While you might first discuss your signs and symptoms with your family doctor, you may be referred to a doctor specializing in infectious diseases or to an orthopedic surgeon.
Here's some information to help you get ready for your appointment, and what to expect from your doctor. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
This content does not have an English version. This content does not have an Arabic version. Diagnosis Your doctor may feel the area around the affected bone for any tenderness, swelling or warmth. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Ferri FF. In: Ferri's Clinical Advisor Philadelphia, Pa.
Accessed Oct. Azar FM, et al. In: Campbell's Operative Orthopaedics. Merck Manual Professional Version. Kremers HM, et al. Trends in the epidemiology of osteomyelitis: A population-based study, to Treatment of osteomyelitis depends on appropriate antibiotic therapy and often requires surgical removal of infected and necrotic tissue. Choice of antibiotic therapy should be determined by culture and susceptibility results, if possible Table 3.
False-negative blood or biopsy cultures are common in patients who have begun antibiotic therapy. If clinically possible, delaying antibiotics is recommended until microbial culture and sensitivity results are available. Indications for surgery include antibiotic failure, infected surgical hardware, and chronic osteomyelitis with necrotic bone and soft tissue.
Enterobacteriaceae e. Fluoroquinolone e. Cefepime, 2 g IV every 8 to 12 hours, plus ciprofloxacin, mg IV every 8 to 12 hours. For patients allergic to vancomycin: Linezolid Zyvox , mg IV every 12 hours. Information from references 31 and Acute hematogenous osteomyelitis in children typically requires a much shorter course of antibiotic therapy than does chronic osteomyelitis in adults. Although randomized controlled trials are lacking, therapy with four days of parenteral antibiotics followed by oral antibiotics for a total of four weeks seems to prevent recurrence in children who have no serious underlying pathology.
Surgical treatment in immunocompetent children is rare. Despite the use of surgical debridement and long-term antibiotic therapy, the recurrence rate of chronic osteomyelitis in adults is about 30 percent at 12 months. The optimal duration of antibiotic treatment and route of delivery are unclear. Antibiotic regimens for the empiric treatment of acute osteomyelitis, particularly in children, should include an agent directed against S.
Betalactam antibiotics are first-line options unless MRSA is suspected. If methicillin resistance among community isolates of Staphylococcus is greater than 10 percent, MRSA should be considered in initial antibiotic coverage.
In patients with diabetic foot infections or penicillin allergies, fluoroquinolones are an alternate option for staphylococcal infections; these agents seem to be as effective as beta-lactams. Data Sources: A PubMed search was completed in Clinical Queries using the key terms osteomyelitis, imaging, diagnosis, and treatment. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. Search date: June 2, Already a member or subscriber?
Log in. Interested in AAFP membership? Learn more. Reprints are not available from the authors. Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics.
Semin Arthritis Rheum. Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects. N Engl J Med. A clinical staging system for adult osteomyelitis. Clin Orthop Relat Res. Kaplan SL. Osteomyelitis in children. Infect Dis Clin North Am.
Are diabetic foot ulcers complicated by MRSA osteomyelitis associated with worse prognosis? Outcomes of a surgical series. Diabet Med. Kohli R, Hadley S. Fungal arthritis and osteomyelitis. Gutierrez K. Bone and joint infections in children. Pediatr Clin North Am. Changing trends in acute osteomyelitis in children: impact of methicillin-resistant Staphylococcus aureus infections.
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Accessed May 31, Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients. Probe-to-bone test for diagnosing diabetic foot osteomyelitis: reliable or relic?
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Diagnosis and treatment of diabetic foot infections. Plast Reconstr Surg. Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: concordance with ulcer swab cultures. Clin Infect Dis.
Current concepts in posttraumatic osteomyelitis: a diagnostic challenge with new imaging options. J Trauma. Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy. Semin Plast Surg. ACR Appropriateness Criteria on suspected osteomyelitis in patients with diabetes mellitus.
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Magnetic resonance imaging for diagnosing foot osteomyelitis: a meta-analysis. Symptoms of osteomyelitis vary, depending on the cause and whether it is a rapid or slow onset of infection. The following are the most common symptoms of osteomyelitis; however, each individual may experience symptoms differently:.
The symptoms of osteomyelitis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis. The provider treating your child will first do a thorough history and physical exam that may indicate signs of osteomyelitis like those listed above. An additional workup generally includes blood tests that look at white blood cells as well as markers for inflammation that are usually elevated during an infection. A blood culture may also be done to look for organisms in the blood that may be causing the infection.
X-rays are taken of the affected area. However, they may be normal in early stages of the infection. Magnetic resonance imaging MRI or bone scans may be recommended to identify the cause of bone pain or inflammation. Computed tomography CT scans can be helpful in later stages of osteomyelitis.
Finally, bone aspirations or biopsies are useful in the diagnosis of osteomyelitis and to determine the most appropriate treatment. In children, these procedures are most often done in the operating room under general anesthesia. The goal for treatment of osteomyelitis is to cure the infection and minimize any long-term complications.
Treatment may include:. Administration of intravenous IV antibiotics , which may require hospitalization or may be given on an outpatient schedule.
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