Osteomyelitis Questions & Answers

1. [Guideline] Concia E, Prandini N, Massari L, Ghisellini F, Consoli V, Menichetti F, et al. Osteomyelitis: clinical update for practical guidelines. Nucl Med Commun. 2006 Aug. 27 (8):645-60. [QxMD MEDLINE Link].

2. Gross T, Kaim AH, Regazzoni P, Widmer AF. Current concepts in posttraumatic osteomyelitis: a diagnostic challenge with new imaging options. J Trauma. 2002 Jun. 52 (6):1210-9. [QxMD MEDLINE Link].

3. Newman LG, Waller J, Palestro CJ, Schwartz M, Klein MJ, Hermann G, et al. Unsuspected osteomyelitis in diabetic foot ulcers. Diagnosis and monitoring by leukocyte scanning with indium in 111 oxyquinoline. JAMA. 1991 Sep 4. 266 (9):1246-51. [QxMD MEDLINE Link].

4. Calhoun JH, Manring MM. Adult osteomyelitis. Infect Dis Clin North Am. 2005 Dec. 19 (4):765-86. [QxMD MEDLINE Link].

5. Thakolkaran N, Shetty AK. Acute Hematogenous Osteomyelitis in Children. Ochsner J. 2019 Summer. 19 (2):116-122. [QxMD MEDLINE Link]. [Full Text].

6. Jaramillo D, Dormans JP, Delgado J, Laor T, St Geme JW 3rd. Hematogenous Osteomyelitis in Infants and Children: Imaging of a Changing Disease. Radiology. 2017 Jun. 283 (3):629-643. [QxMD MEDLINE Link]. [Full Text].

7. Carapetis J, Steer A. Bone and joint infections. Obgyn Key. Available at https://obgynkey.com/bone-and-joint-infections/. August 4, 2016; Accessed: July 11, 2022.

8. Wheeless CR III. General features and pathology of hematogenous osteomyelitis. Wheeless' Textbook of Orthopaedics. Available at https://www.wheelessonline.com/ortho/general_features_and_pathology_of_hematogenous_osteomyelitis. 2022; Accessed: July 11, 2022.

9. Paluska SA. Osteomyelitis. Clinics in Family Practice. 2004. 6:127-56.

10. Shaw BA, Kasser JR. Acute septic arthritis in infancy and childhood. Clin Orthop Relat Res. 1990 Aug. 257:212-25. [QxMD MEDLINE Link].

11. Vincent GM, Amirault JD. Septic arthritis in the elderly. Clin Orthop Relat Res. 1990 Feb. 251:241-5. [QxMD MEDLINE Link].

12. Courjon J, Lemaignen A, Ghout I, Therby A, Belmatoug N, Dinh A, et al. Pyogenic vertebral osteomyelitis of the elderly: Characteristics and outcomes. PLoS One. 2017. 12 (12):e0188470. [QxMD MEDLINE Link]. [Full Text].

13. Peltola H, Pääkkönen M. Acute osteomyelitis in children. N Engl J Med. 2014 Jan 23. 370 (4):352-60. [QxMD MEDLINE Link].

14. Belthur MV, Birchansky SB, Verdugo AA, Mason EO Jr, Hulten KG, Kaplan SL, et al. Pathologic fractures in children with acute Staphylococcus aureus osteomyelitis. J Bone Joint Surg Am. 2012 Jan 4. 94 (1):34-42. [QxMD MEDLINE Link].

15. Beronius M, Bergman B, Andersson R. Vertebral osteomyelitis in Göteborg, Sweden: a retrospective study of patients during 1990-95. Scand J Infect Dis. 2001. 33 (7):527-32. [QxMD MEDLINE Link].

16. Digby JM, Kersley JB. Pyogenic non-tuberculous spinal infection: an analysis of thirty cases. J Bone Joint Surg Br. 1979 Feb. 61 (1):47-55. [QxMD MEDLINE Link].

17. Momodu II, Savaliya V. Osteomyelitis. Treasure Island, FL: StatPearls; 2022. [Full Text].

18. Schreiber VM, Illingworth KD, Ward WT. Treating orthopedic infections in pediatric patients. Oper Tech Orthop. 2016 Mar 1. 26 (1):12-9.

19. Panteli M, Giannoudis PV. Chronic osteomyelitis: what the surgeon needs to know. EFORT Open Rev. 2016 May. 1 (5):128-135. [QxMD MEDLINE Link]. [Full Text].

20. Tseng CH, Huang WS, Muo CH, Kao CH. Increased risk of dementia among chronic osteomyelitis patients. Eur J Clin Microbiol Infect Dis. 2015 Jan. 34 (1):153-159. [QxMD MEDLINE Link].

21. Hassan AS, Rao A, Manadan AM, Block JA. Peripheral Bacterial Septic Arthritis: Review of Diagnosis and Management. J Clin Rheumatol. 2017 Dec. 23 (8):435-442. [QxMD MEDLINE Link].

22. Jordanov MI, Block JJ, Gonzalez AL, Green NE. Transarticular spread of Ewing sarcoma mimicking septic arthritis. Pediatr Radiol. 2009 Apr. 39 (4):381-4. [QxMD MEDLINE Link].

23. Jaramillo D, Dormans JP, Delgado J, Laor T, St Geme JW 3rd. Hematogenous Osteomyelitis in Infants and Children: Imaging of a Changing Disease. Radiology. 2017 Jun. 283 (3):629-643. [QxMD MEDLINE Link]. [Full Text].

24. Bernard L, Lübbeke A, Stern R, Bru JP, Feron JM, Peyramond D, et al. Value of preoperative investigations in diagnosing prosthetic joint infection: retrospective cohort study and literature review. Scand J Infect Dis. 2004. 36 (6-7):410-6. [QxMD MEDLINE Link].

25. Spangehl MJ, Masri BA, O'Connell JX, Duncan CP. Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am. 1999 May. 81 (5):672-83. [QxMD MEDLINE Link].

26. Lew DP, Waldvogel FA. Osteomyelitis. Lancet. 2004 Jul 24-30. 364 (9431):369-79. [QxMD MEDLINE Link].

27. [Guideline] Expert Panel on Musculoskeletal Imaging:., Beaman FD, von Herrmann PF, Kransdorf MJ, Adler RS, Amini B, et al. ACR Appropriateness Criteria^® Suspected Osteomyelitis, Septic Arthritis, or Soft Tissue Infection (Excluding Spine and Diabetic Foot). J Am Coll Radiol. 2017 May. 14 (5S):S326-S337. [QxMD MEDLINE Link].

28. Palestro CJ. Radionuclide Imaging of Musculoskeletal Infection: A Review. J Nucl Med. 2016 Sep. 57 (9):1406-12. [QxMD MEDLINE Link]. [Full Text].

29. Abiri MM, Kirpekar M, Ablow RC. Osteomyelitis: detection with US. Radiology. 1989 Aug. 172 (2):509-11. [QxMD MEDLINE Link].

30. Howard CB, Einhorn M, Dagan R, Nyska M. Ultrasound in diagnosis and management of acute haematogenous osteomyelitis in children. J Bone Joint Surg Br. 1993 Jan. 75 (1):79-82. [QxMD MEDLINE Link].

31. Wheat J. Diagnostic strategies in osteomyelitis. Am J Med. 1985 Jun 28. 78 (6B):218-24. [QxMD MEDLINE Link].

32. Crymes WB Jr, Demos H, Gordon L. Detection of musculoskeletal infection with 18F-FDG PET: review of the current literature. J Nucl Med Technol. 2004 Mar. 32 (1):12-5. [QxMD MEDLINE Link]. [Full Text].

33. Howard CB, Einhorn M, Dagan R, Yagupski P, Porat S. Fine-needle bone biopsy to diagnose osteomyelitis. J Bone Joint Surg Br. 1994 Mar. 76 (2):311-4. [QxMD MEDLINE Link].

34. Perry CR, Pearson RL, Miller GA. Accuracy of cultures of material from swabbing of the superficial aspect of the wound and needle biopsy in the preoperative assessment of osteomyelitis. J Bone Joint Surg Am. 1991 Jun. 73 (5):745-9. [QxMD MEDLINE Link].

35. Waldvogel FA, Medoff G, Swartz MN. Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects. 3. Osteomyelitis associated with vascular insufficiency. N Engl J Med. 1970 Feb 5. 282 (6):316-22. [QxMD MEDLINE Link].

36. Cierny G 3rd, Mader JT, Penninck JJ. A clinical staging system for adult osteomyelitis. Clin Orthop Relat Res. 2003 Sep. (414):7-24. [QxMD MEDLINE Link].

37. Gordon L, Chiu EJ. Treatment of infected non-unions and segmental defects of the tibia with staged microvascular muscle transplantation and bone-grafting. J Bone Joint Surg Am. 1988 Mar. 70 (3):377-86. [QxMD MEDLINE Link].

38. Mader JT, Shirtliff M, Calhoun JH. Staging and staging application in osteomyelitis. Clin Infect Dis. 1997 Dec. 25 (6):1303-9. [QxMD MEDLINE Link].

39. Ger R. Muscle transposition for treatment and prevention of chronic post-traumatic osteomyelitis of the tibia. J Bone Joint Surg Am. 1977 Sep. 59(6):784-91. [QxMD MEDLINE Link].

40. Weiland AJ, Moore JR, Daniel RK. The efficacy of free tissue transfer in the treatment of osteomyelitis. J Bone Joint Surg Am. 1984 Feb. 66 (2):181-93. [QxMD MEDLINE Link].

41. Kelly PJ. Infected nonunion of the femur and tibia. Orthop Clin North Am. 1984 Jul. 15 (3):481-90. [QxMD MEDLINE Link].

42. [Guideline] Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, et al. 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adultsa. Clin Infect Dis. 2015 Sep 15. 61 (6):e26-46. [QxMD MEDLINE Link].

43. Zalavras CG, Patzakis MJ, Holtom P. Local antibiotic therapy in the treatment of open fractures and osteomyelitis. Clin Orthop Relat Res. 2004 Oct. (427):86-93. [QxMD MEDLINE Link].

44. Lázaro-Martínez JL, Aragón-Sánchez J, García-Morales E. Antibiotics versus conservative surgery for treating diabetic foot osteomyelitis: a randomized comparative trial. Diabetes Care. 2014. 37 (3):789-95. [QxMD MEDLINE Link]. [Full Text].

45. Zimmerli W, Widmer AF, Blatter M, Frei R, Ochsner PE. Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. Foreign-Body Infection (FBI) Study Group. JAMA. 1998 May 20. 279 (19):1537-41. [QxMD MEDLINE Link]. [Full Text].

46. Gateley DR, Irby SJ, Martin DL, Simonis RB. Ilizarov bone transport for the treatment of chronic osteomyelitis: a rare complication. J R Soc Med. 1996 Jun. 89 (6):348P-50P. [QxMD MEDLINE Link]. [Full Text].

47. Krappinger D, Irenberger A, Zegg M, Huber B. Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment. Arch Orthop Trauma Surg. 2013 Jun. 133 (6):789-95. [QxMD MEDLINE Link].

48. Rosenfeld SR. The Ilizarov method. West J Med. 1995 Dec. 163 (6):568. [QxMD MEDLINE Link].

49. Louie KW. Ilizarov method. West J Med. 1991 Aug. 155 (2):170. [QxMD MEDLINE Link].

50. Mifsud M, McNally M. Local delivery of antimicrobials in the treatment of bone infections. Orthop Trauma J. 2019 Jun 1. 33 (3):160-5.

51. Walenkamp GH, Vree TB. Treatment of a patient with impaired renal function with gentamicin-PMMA-beads. Arch Orthop Trauma Surg. 1981. 99 (2):137-41. [QxMD MEDLINE Link].

52. Nowinski RJ, Gillespie RJ, Shishani Y, Cohen B, Walch G, Gobezie R. Antibiotic-loaded bone cement reduces deep infection rates for primary reverse total shoulder arthroplasty: a retrospective, cohort study of 501 shoulders. J Shoulder Elbow Surg. 2012 Mar. 21 (3):324-8. [QxMD MEDLINE Link].

53. Yousefi AM. A review of calcium phosphate cements and acrylic bone cements as injectable materials for bone repair and implant fixation. J Appl Biomater Funct Mater. 2019 Oct-Dec. 17 (4):2280800019872594. [QxMD MEDLINE Link].

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55. Wininger DA, Fass RJ. Antibiotic-impregnated cement and beads for orthopedic infections. Antimicrob Agents Chemother. 1996 Dec. 40 (12):2675-9. [QxMD MEDLINE Link]. [Full Text].

56. Sasaki T, Ishibashi Y, Katano H, Nagumo A, Toh S. In vitro elution of vancomycin from calcium phosphate cement. J Arthroplasty. 2005 Dec. 20 (8):1055-9. [QxMD MEDLINE Link].

57. Hamanishi C, Kitamoto K, Tanaka S, Otsuka M, Doi Y, Kitahashi T. A self-setting TTCP-DCPD apatite cement for release of vancomycin. J Biomed Mater Res. 1996 Fall. 33 (3):139-43. [QxMD MEDLINE Link].

58. Sasaki S, Ishii Y. Apatite cement containing antibiotics: efficacy in treating experimental osteomyelitis. J Orthop Sci. 1999. 4 (5):361-9. [QxMD MEDLINE Link].

59. Ferguson J, Diefenbeck M, McNally M. Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections. J Bone Jt Infect. 2017. 2 (1):38-51. [QxMD MEDLINE Link]. [Full Text].

60. McNally MA, Ferguson JY, Lau AC, Diefenbeck M, Scarborough M, Ramsden AJ, et al. Single-stage treatment of chronic osteomyelitis with a new absorbable, gentamicin-loaded, calcium sulphate/hydroxyapatite biocomposite: a prospective series of 100 cases. Bone Joint J. 2016 Sep. 98-B (9):1289-96. [QxMD MEDLINE Link].

61. Ferguson J, Diefenbeck M, McNally M. Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections. J Bone Jt Infect. 2017. 2 (1):38-51. [QxMD MEDLINE Link]. [Full Text].

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66. Qiu XS, Chen YX, Qi XY, Shi HF, Wang JF, Xiong J. Outcomes of cement beads and cement spacers in the treatment of bone defects associated with post-traumatic osteomyelitis. BMC Musculoskelet Disord. 2017 Jun 12. 18 (1):256. [QxMD MEDLINE Link].

67. Cho JW, Kim J, Cho WT, Kim JK, Song JH, Kim HJ, et al. Circumferential bone grafting around an absorbable gelatin sponge core reduced the amount of grafted bone in the induced membrane technique for critical-size defects of long bones. Injury. 2017 Oct. 48 (10):2292-2305. [QxMD MEDLINE Link].

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Jigar Gandhi, MD, PharmD Resident Physician, Department of Orthopaedics, Cooper Bone and Joint Institute, Cooper University Health Care

Disclosure: Nothing to disclose.

Ravi Ponnappan, MD, FAAOS Attending Physician, Department of Orthopaedic Surgery, Division of Spinal Surgery, Cooper Bone and Joint Institute, Cooper University Health Care; Associate Professor of Orthopaedic Surgery, Cooper Medical School of Rowan University

Ravi Ponnappan, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Cervical Spine Research Society, North American Spine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Murali Poduval, MBBS, MS, DNB Orthopaedic Surgeon, Senior Consultant, and Subject Matter Expert, Tata Consultancy Services, Mumbai, India

Murali Poduval, MBBS, MS, DNB is a member of the following medical societies: Association of Medical Consultants of Mumbai, Bombay Orthopedic Society, Indian Orthopedic Association, Indian Society of Hip and Knee Surgeons

Disclosure: Nothing to disclose.

Stephen Kishner, MD, MHA Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans

Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Steven I Rabin, MD, FAAOS Clinical Associate Professor, Department of Orthopedic Surgery and Rehabilitation, Loyola University, Chicago Stritch School of Medicine; Medical Director, Musculoskeletal Services, Dreyer Medical Clinic

Steven I Rabin, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Fracture Association, American Orthopaedic Association, AO Foundation, Chicago Metropolitan Trauma Society, Illinois Association of Orthopaedic Surgeons, Limb Lengthening and Reconstruction Society, Mid-America Orthopaedic Association, Orthopaedic Trauma Association

Disclosure: Nothing to disclose.

James Monroe Laborde, MD, MS Clinical Assistant Professor, Department of Orthopedics, Louisiana State University Health Sciences Center and Tulane Medical School; Board of Advisors, Department of Biomedical Engineering, Tulane University; Adjunct Assistant Professor, Department of Physical Medicine and Rehabilitation, Louisiana State University Medical School

James Monroe Laborde, MD, MS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Farheen Arshia Khan, DO Resident Physician, Department of Physical Medicine and Rehabilitation, Louisiana State University Health Science Center

Disclosure: Nothing to disclose.

Sarah E Clevenger, MD Chief Resident Physician, Department of Physical Medicine and Rehabilitation, Louisiana State University School of Medicine in New Orleans

Sarah E Clevenger, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Medical Association

Disclosure: Nothing to disclose.

Gavin C Nixon, DO Resident Physician, Department of Physical Medicine and Rehabilitation, Louisiana State University School of Medicine in New Orleans

Disclosure: Nothing to disclose.

Elena Khoutorova Hart, MD Resident Physician, Department of Physical Medicine and Rehabilitation, Louisiana State University School of Medicine in New Orleans

Elena Khoutorova Hart, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Christian Medical and Dental Associations, Louisiana State Medical Society

Disclosure: Nothing to disclose.

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