Osteomyelitis

Background

• Infection of the bone by bacteria or fungus
• Etiology
  • Contiguous spread (80%)
  • Hematogenous spread (20%)
    • More common in peds (long bones)
    • Less common in adults (spine)

Risk Factors

• Diabetic pts with one or more of the following:
  • Skin ulceration >2cm
  • Positive probe-to-bone test
  • ESR >70 (83-92% Sn)
  • Abnormal x-ray

Diagnosis

• Pain at the site
  • May also have warmth, swelling, erythema
• X-ray
  • May be normal early in the course
  • Later will show bone demineralization, periosteal elevation, lytic lesions
• Blood culture
• Bone scan

Source

Tintinalli