defining characteristics
Increasing pain, skull/mandible/ small bones hand/ long bones/feet, mild fever, minimal drainage
Diabetic osteomyelitis? Painless (due to peripheral neuropathy in most DM pts) ulcer extending to bone, mild cellulitis, crepitance [If it probes to the bone, it’s osteomyelitis]
disease development
Bacterial infection from localized ulceration/ trauma travel further to the bone
potential causes
Possible polymicrobial (see diabetic foot ulcer bacteria)
Mixed gram+/-, anaerobes
epidemiology
MOST common in adults
risk factors
Chronic skin ulcers (arterial sclerotic dz), trauma, diabetes, post-op ortho surgery, chronic edema
labimaging
Imaging hard to interpret bc surrounding soft tissue inf
Bone scan sometimes reveals contiguous spread from ulcer site
Bone sample for culture
conventional treatment
Revascularization
Amputation/ surgical debridement
Abs for 4-8wks (Avoid empiric ab tx)
