Osteomyelitis laboratory findings: Difference between revisions

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{{Osteomyelitis}}
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==Overview==
Laboratory findings in osteomyelitis include increased acute phase reactants ([[ESR]] and [[CRP]]) levels and [[leukocytosis]].<ref name="pmid19533263">{{cite journal |vauthors=Pääkkönen M, Kallio MJ, Kallio PE, Peltola H |title=Sensitivity of erythrocyte sedimentation rate and C-reactive protein in childhood bone and joint infections |journal=Clin. Orthop. Relat. Res. |volume=468 |issue=3 |pages=861–6 |year=2010 |pmid=19533263 |pmc=2816763 |doi=10.1007/s11999-009-0936-1 |url=}}</ref> 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.


{{CMG}}
==Laboratory Findings==
==Laboratory Findings==
Diagnosis of osteomyelitis is often based on [[radiology|radiologic]] results showing a [[lytic]] center with a ring of [[sclerosis]], though bone cultures are normally required to identify the specific pathogen.
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.


*Blood cultures
Isolation techniques to determine the causative agent include:
*Bone biopsy (which is then cultured)
*[[Blood culture]]s
*Complete blood count (CBC)
*Bone [[biopsy]] (which is then cultured)
*C-reactive protein (CRP)
 
*Erythrocyte sedimentation rate (ESR)
Laboratory tests to determine infection include:<ref name="pmid8265325">{{cite journal| author=Unkila-Kallio L, Kallio MJ, Eskola J, Peltola H| title=Serum C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in acute hematogenous osteomyelitis of children. | journal=Pediatrics | year= 1994 | volume= 93 | issue= 1 | pages= 59-62 | pmid=8265325 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8265325  }} </ref><ref name="pmid16291067">{{cite journal |vauthors=Cavanagh PR, Lipsky BA, Bradbury AW, Botek G |title=Treatment for diabetic foot ulcers |journal=Lancet |volume=366 |issue=9498 |pages=1725–35 |year=2005 |pmid=16291067 |doi=10.1016/S0140-6736(05)67699-4 |url=}}</ref>
*Needle aspiration of the area around affected bones
*[[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==
==References==
{{Reflist|2}}


{{Reflist|2}}
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Latest revision as of 23:28, 29 July 2020

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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:

Laboratory tests to determine infection include:[2][3]

References

  1. 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.
  2. 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.
  3. 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.