Osteomyelitis

Paul Auwaerter, M.D.

Osteomyelitis is a topic covered in the Johns Hopkins Diabetes Guide.

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DEFINITION

Osteomyelitis (OM): infection of the bone.
- Acute OM: first presentation of osteomyelitis, < 2 weeks duration, no bony necrosis/sequestrum, usually hematogenously acquired and more commonly seen in children.
- Chronic OM: not clearly defined but may include failure of prior OM treatment, symptoms >3 weeks, presence of necrotic bone/sinus tract or discharge.
  - Diagnosis often difficult, especially with pressured decision-making in hospital settings, or outpatient evaluations without easy access to willing sub-specialists/diabetic foot infection (DFI)-comprehensive management teams.
No robust evidence to back definitions or guidelines for treatment of OM in the setting of DFI.
Two general categories of OM:
- Occurring within the context of DFI (most common by far)
- Other sites, e.g., vertebral.

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DEFINITION

Osteomyelitis (OM): infection of the bone.
- Acute OM: first presentation of osteomyelitis, < 2 weeks duration, no bony necrosis/sequestrum, usually hematogenously acquired and more commonly seen in children.
- Chronic OM: not clearly defined but may include failure of prior OM treatment, symptoms >3 weeks, presence of necrotic bone/sinus tract or discharge.
  - Diagnosis often difficult, especially with pressured decision-making in hospital settings, or outpatient evaluations without easy access to willing sub-specialists/diabetic foot infection (DFI)-comprehensive management teams.
No robust evidence to back definitions or guidelines for treatment of OM in the setting of DFI.
Two general categories of OM:
- Occurring within the context of DFI (most common by far)
- Other sites, e.g., vertebral.

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