Osteomyelitis

Investigations:

• Blood cultures recommended. If positive, repeat blood cultures to ensure clearance of bacteremia.
• CBC and differential, serum creatinine.
• ESR, CRP (may be useful to follow response but normal initial values do not exclude diagnosis).
• Plain x-ray +/- MRI, or bone scan +/- WBC scan
  • MRI superior to x-ray and bone scan for early diagnosis of bone/joint infections
  • bone scan may be falsely positive if recent trauma/aspiration of joint/superficial infection

Therapy:

- Clindamycin achieves excellent bone penetration and is a good agent for osteomyelitis if organism susceptible. However due to high resistance rates, not recommended empirically.