Osteomyelitis: approach to diagnosis and treatment

Osteomyelitis is a common disease with a variety of clinically and microbiologically distinct subsets. Diagnosis should begin with plain radiographs but may include a variety of imaging modalities. Cultures of the surface of ulcers or draining sinuses are often misleading, and bone cultures are necessary to determine the true pathogens of bone infections. The approach to treatment of osteomyelitis is complex, and often requires a multidisciplinary approach, with input from radiologists, vascular and orthopedic surgeons, infectious disease specialists, and wound care and rehabilitation specialists.