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Osteomyelitis

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  1. Classification: Waldvogel System
    1. Acute Osteomyelitis: Hematogenous Seeding
      1. Child with long bone metaphysis infection
    2. Chronic osteomyelitis: Wound associated
      1. Adult with open injury to bone and soft tissue
    3. Contiguous spread of infection
      1. No generalized vascular disease
      2. Generalized vascular disease
  2. Etiology
    1. See Osteomyelitis Causes
  3. Symptoms and Signs: Acute Osteomyelitis
    1. Presentation within one week of symptom onset
    2. Local signs of infection
      1. Tenderness on palpation over involved bone
      2. Decreased range of motion of adjacent joints
    3. Systemic signs of infection
      1. Fever
      2. Irritability or lethargy
  4. Symptoms and Signs: Chronic and Subacute Osteomyelitis
    1. Localized bone pain
    2. Erythema and swelling at affected area
    3. Draining sinus tracts
    4. Decreased range of motion of adjacent joints
    5. Diminished blood supply
  5. Signs: Predictive of Osteomyelitis
    1. Probe-to-Bone Test
    2. Skin Ulceration over a bony prominence
      1. Ulcer present over 2 weeks
      2. Ulcer over 2 cm in size
        1. Test Sensitivity: 56%
        2. Specificity: 92%
      3. Ulcer depth exceeds 3 mm
  6. Labs
    1. Complete Blood Count (CBC)
      1. Leukocytosis
    2. Erythrocyte Sedimentation Rate (ESR) exceeds 70
      1. Test Sensitivity: 28%
    3. C-Reactive Protein (CRP)
    4. Bone Biopsy (Gold Standard)
      1. Test Sensitivity: 95%
      2. Specificity: 99%
  7. Imaging
    1. See Osteomyelitis XRay
    2. See Osteomyelitis Bone Scan
    3. See Osteomyelitis MRI
    4. See Osteomyelitis CT
    5. Bone Ultrasound Findings
      1. Bone abscess
      2. Periostitis
  8. Management
    1. See Osteomyelitis Management
    2. See Suspected Osteomyelitis in Diabetes Mellitus
  9. References
    1. Boutin (1998) Orthop Clin North Am 29:41
    2. Carek (2001) Am Fam Physician 63(12):2413
    3. Dirschl (1993) Drugs 45:29
    4. Eckman (1995) JAMA 273:712
    5. Haas (1996) Am J Med 101:550
    6. Lew (1997) N Engl J Med 336:999
    7. Lipsky (1997) Clin Infect Dis 25:1318

Osteomyelitis (C0029443)

Definition (CSP)inflammation of the bone marrow and adjacent bone caused by a pyogenic organism; it may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum.
ConceptsDisease or Syndrome (T047)
ICD9730.2, 730.20, 730.9, 730.90
MSHD010019
EnglishBone infection, Infection of bone, OM - Osteomyelitis, Osteomyelitides, Osteomyelitis, OSTM - Osteomyelitis, Pyogenic inflammation of bone, Unspecified infection of bone, Unspecified osteomyelitis, Unspecified osteomyelitis of unspecified site
Spanishinfeccion de hueso, infeccion del hueso, infeccion osea, inflamacion piogena del hueso, osteomielitis
Parent ConceptsInfectious Disease Status: Past or Present Infections (C0150884), Present or past infectious disease (C0150943), Osteomyelitis (C0029443), osteopathy, chondropathy, acquired deformity (C0679391), Bone Diseases (C0005940), Disorder of skeletal system (C0263661), Bone Disorders, General and NEC (C0549572), Osteomyelitis, periostitis and other infections affecting bone (C0343139), Bone Diseases, Infectious (C0005943), Infectious Disorder by Site (C1334175), Non-Neoplastic Bone Disorder (C1334997), Osteitis (C0029400), Infections of musculoskeletal system (C0851162), Bone Marrow Diseases (C0005956), Ambiguous concept (C1274012), Duplicate concept (C1274013), Inflammation of specific body organs (C1285331)
SourcesAIR, AOD, COSTAR, CSP, CST, DXP, ICD9CM, LCH, MEDLINEPLUS, MSH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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