Bone infection - Diagnosing osteomyelitis

Osteomyelitis is diagnosed based on a physical examination and tests including blood tests, imaging tests and a biopsy.

Visit your GP if you are experiencing symptoms of osteomyelitis, such as a high temperature and bone pain.

Physical examination

Your GP will first carry out a physical examination of the affected body part to check for redness, swelling and tenderness.

They will want to know whether you have recently had an injury, surgery or a previous infection.

If osteomyelitis is suspected, they may refer you to an orthopaedic surgeon (a specialist in bones and joints).

Blood test

You may be referred for a blood test. This cannot confirm osteomyelitis, but can indicate whether you have a high number of white blood cells in your blood, which is a sign of an infection.

Also, if the osteomyelitis was caused by bacteria spreading in your blood, a blood test may be useful for detecting the bacteria.

Imaging tests

There are several imaging tests used to detect bone damage caused by osteomyelitis. They include:

  • X-rays, where low levels of radiation are used to create an image of the affected bone – this test is not usually useful for diagnosis if the condition is in the early stages.
  • magnetic resonance imaging (MRI) scan, where a strong magnetic field and radio waves are used to build up a picture of the inside of the affected bone
  • computerised tomography (CT) scan, where a series of X-rays of your affected bone are taken and a computer is used to assemble them into a more detailed three-dimensional image
  • ultrasound scan, where high-frequency sound waves are used to create an image of the affected bone to highlight any abnormalities

Biopsy

If tests suggest osteomyelitis, it is usually necessary to remove a small sample of bone for further testing. This is known as a biopsy.

A biopsy is usually necessary to confirm osteomyelitis and can help establish the type of bacteria or fungus causing your infection. This is useful when deciding on the most effective treatment.

A biopsy is usually combined with surgery in chronic cases.

If you have a wound producing pus, a sample may also be taken for testing.



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