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Osteomyelitis of the calcaneum
E H Wang1, S Simpson, G C Bennet
1Royal Hospital for Sick Children, Glasgow, Scotland.
The Journal of Bone and Joint Surgery. British Volume
|November 1, 1992
Summary
Early diagnosis of calcaneal osteomyelitis is crucial for effective antibiotic treatment. Clinical examination, including a new physical sign, is key, as standard tests are often unreliable.
Area of Science:
- Orthopedics
- Infectious Diseases
- Podiatry
Background:
- Osteomyelitis of the calcaneum (heel bone) presents differently than long-bone infections.
- Accurate diagnosis is essential for timely and effective treatment.
Purpose of the Study:
- To analyze clinical features, diagnostic methods, and treatment outcomes for calcaneal osteomyelitis.
- To identify key factors for successful management and introduce a new diagnostic sign.
Main Methods:
- Retrospective review of 52 cases of calcaneal osteomyelitis.
- Analysis of clinical symptoms, laboratory tests (blood/tissue cultures, hematology), and radiological findings.
- Evaluation of treatment responses and complications.
Main Results:
- Clinical signs were distinct from long-bone osteomyelitis.
- Blood cultures were positive in 41%, tissue cultures in 91%.
- Hematological tests had limited value; radiological changes were often delayed or absent (12%).
Conclusions:
- Early clinical diagnosis is paramount for successful treatment of calcaneal osteomyelitis.
- Antibiotic therapy alone can be effective with early intervention.
- Delayed diagnosis increases the risk of complications and chronic infection.