bone, joint, and muscle disorders
Osteomyelitis
Diagnosis of Osteomyelitis
Blood tests Imaging tests, such as x-rays, computed tomography (CT), magnetic resonance imaging (MRI), a bone scan, or a white blood cell scan Symptoms and findings found by doctors during a physical examination may suggest osteomyelitis. For example, doctors may suspect osteomyelitis in a person who has persistent unexplained pain in part of a bone, who may or may not have a fever, and who feels tired much of the time. If doctors suspect osteomyelitis, they do a blood test for inflammation by measuring one of the following: Erythrocyte sedimentation rate (ESR—a test that measures the rate at which red blood cells settle to the bottom of a test tube containing blood) Level of C-reactive protein (a protein that circulates in the blood and dramatically increases in level when there is inflammation) Inflammation is usually present if the ESR or C-reactive protein level is increased. Also, blood tests often indicate elevated levels of white blood cells. The results of these blood tests are not enough to make the diagnosis of osteomyelitis. However, results that show little or no inflammation may suggest a person doesnothave osteomyelitis. An X-rays may show changes characteristic of osteomyelitis but sometimes not until 2 to 4 weeks after the first symptoms occur. If x-ray results are unclear or if symptoms are severe, Computed tomography (CT) and magnetic resonance imaging (MRI) (CT) or Alternatively, a Bone scanning (images of bone made after injecting a substance called radioactive technetium) may be done. The infected area almost always appears abnormal on bone scans, except in infants because scans may not reliably indicate abnormalities in growing bones. However, a bone scan cannot always distinguish infections from other bone disorders. White blood cell scans (images made after radioactive indium–labeled white blood cells are injected into a vein) can help distinguish between infection and other disorders in areas that are abnormal on bone scans. To diagnose a bone infection and identify the organisms causing it, doctors may take samples of blood, pus, joint fluid, or the bone itself to test. Usually, for vertebral osteomyelitis, samples of bone tissue are removed with a needle or during surgery. 