Osteomyelitis - Diagnosis

Laboratory studies:Identify the disease agent in blood, bone, joint aspirate before antibioticLeukocytosis is notedC-reactive protein and erythrocyte sedimentation rate are high.
Imaging Studies:X-ray shows bone changes at 5-7 days of infection. They are useful to exclude other causes of pain such as bone stress fractures.Plain radiography and radionuclide scanning to help early diagnosis of acute osteomyelitis. Radiograph is useful to exclude other conditions.
Scanning scintigraphy is highly sensitive for diagnosing osteomyelitis. This procedure is performed in three stages. It is used to create images teghnetiu 99 and determine the areas of infection and bone remodeling depending on the flow of blood.Sensitivity method cunosaste not help when the location and spread of the infection.
Three-dimensional CT scanning allows the examination of the bone and surrounding soft tissue. It is an excellent method to detect new bone formations periostiale and cortical bone destruction and to determine the presence or involucrumului seizure.
MRI is another useful tool for imaging acute osteomyelitis. It accurately detects the structure of extension and the area affected by the disease. Reported sensitivity is 88-100%. Infection and inflammation can not be distinguished, however. The imaging modality of choice for infections spine, pelvis or limbs because of their ability to bring details of the changes in bone and soft tissue expansion in the masses.
The needle biopsy or needle aspiration are used under ultrasound, fluoroscopy or computer tomography guidance to get samples of pus, tissue and histological diagnosis of acute osteomyelitis.
Histological examination: The three basic components of bacterial osteomyelitis are acute inflammatory exudate neutrophils, necrotic bone and intracellular bacteria. Bacteria are identified by Gram stain or culture.
The differential diagnosis is made with the following conditions: Ewing's sarcoma, septic arthritis, stress fracture, chronic osteomyelitis, osteosarcoma, sickle cell disease, acute rheumatism, juvenile arthritis, Gaucher disease, eosinophilic granuloma.