Osteomyelitis laboratory findings: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Osteomyelitis}} | {{Osteomyelitis}} | ||
{{CMG}} {{AE}} {{NRM}} | {{CMG}}; {{AE}} {{NRM}}, {{MehdiP}} | ||
==Overview== | ==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. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
Microbiology and histopathology are essential for diagnosis and determining treatment of osteomyelitis. | Microbiology and histopathology are essential for diagnosis and determining treatment of osteomyelitis. | ||
*Histopathology of bone biopsy samples typically provides the most accurate diagnosis. | *Histopathology of bone biopsy samples typically provides the most accurate diagnosis. | ||
*Blood cultures are typically more reliable for hematogenous or vertebral | *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. | *Samples obtained from swabbing sinus tracts should not be used as the isolate may be contaminated with non-pathogenic microorganisms. | ||
Isolation techniques to determine causative agent include: | Isolation techniques to determine the causative agent include: | ||
*[[Blood culture]]s | *[[Blood culture]]s | ||
*Bone [[biopsy]] (which is then cultured) | *Bone [[biopsy]] (which is then cultured) | ||
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> | 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> | ||
*[[Complete blood count]] (CBC) | *[[Complete blood count]] (CBC) | ||
*[[C-reactive protein]] (CRP) | *[[C-reactive protein]] (CRP) | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
[[Category: | [[Category:Emergency mdicine]] | ||
[[Category: | [[Category:Disease]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
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:
- 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.