Osteomyelitis

Question 1

What is osteomyelitis?

Answer 1

Infection of the bone

Question 2

How can infections spread to the bone and cause osteomyelitis?

Answer 2

Haematogenous spread
Direct inoculation - e.g. following an open fracture or penetrating injury
Direct spread from a nearby infection

Question 3

What are some risk factors for osteomyelitis?

Answer 3

Diabetes mellitus
Immunosupression - e.g. long term steroid treatment
Alcohol excess
IV drug use

Question 4

How does osteomyelitis present?

Answer 4

Severe pain in affected region
Low grade fever
Possible history of trauma
Site tender with swelling and erythema

*in diabetic foot the pain may be absent due to peripheral neuropathy

Question 5

What investigations are done for osteomyelitis?

Answer 5

Bloods
Blood cultures
X-RAYS are often done but often don;t show much

MRI imaging - osteopenia, periosteal thickening etc.

Bone biopsy at debridement - gold standard diagnosis