Osteomyelitis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A., Seyedmahdi Pahlavani, M.D. [2]
Overview
Laboratory findings in osteomyelitis include increased acute phase reactants (ESR and CRP) levels and leukocytosis.[1] Blood cultures should be performed in all suspected cases. Bone probing and direct sampling is a reliable method, especially in diabetic ulcers which are contaminated with many flora.
Laboratory Findings
Microbiology and histopathology are essential for diagnosis and determining treatment of osteomyelitis.
- Histopathology of bone biopsy samples typically provides the most accurate diagnosis.
- Blood cultures are typically more reliable for hematogenous or vertebral osteomyelitis.
- Samples obtained from swabbing sinus tracts should not be used as the isolate may be contaminated with non-pathogenic microorganisms.
Isolation techniques to determine the causative agent include:
- Blood cultures
- Bone biopsy (which is then cultured)
Laboratory tests to determine infection include:[2][3]
- Complete blood count (CBC)
- C-reactive protein (CRP)
- Erythrocyte sedimentation rate (ESR)
- Note: white blood cell count (WBC) is typically normal and therefore not reliable
References
- ↑ Pääkkönen M, Kallio MJ, Kallio PE, Peltola H (2010). "Sensitivity of erythrocyte sedimentation rate and C-reactive protein in childhood bone and joint infections". Clin. Orthop. Relat. Res. 468 (3): 861–6. doi:10.1007/s11999-009-0936-1. PMC 2816763. PMID 19533263.
- ↑ Unkila-Kallio L, Kallio MJ, Eskola J, Peltola H (1994). "Serum C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in acute hematogenous osteomyelitis of children". Pediatrics. 93 (1): 59–62. PMID 8265325.
- ↑ Cavanagh PR, Lipsky BA, Bradbury AW, Botek G (2005). "Treatment for diabetic foot ulcers". Lancet. 366 (9498): 1725–35. doi:10.1016/S0140-6736(05)67699-4. PMID 16291067.