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Osteomyelitis beneath pressure sores.

B Sugarman, S Hawes, D M Musher

Archives of Internal Medicine

|April 1, 1983

Summary

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Diagnosing osteomyelitis in pressure sores requires careful evaluation. While bone scans show increased uptake in osteomyelitis, histological examination of bone is essential for definitive diagnosis and guiding antibacterial treatment.

Area of Science:

Orthopedics
Infectious Diseases
Radiology

Background:

Pressure sores can lead to serious complications like osteomyelitis.
Accurate diagnosis of osteomyelitis in pressure sores is challenging.

Purpose of the Study:

To evaluate diagnostic methods for osteomyelitis in pressure sores.
To correlate histological findings with imaging and culture results.

Main Methods:

Prospective evaluation of 28 pressure sores.
Histological examination of bone.
Roentgenography and Technetium Tc 99m medronate bone scans.
Bone biopsy cultures.

Main Results:

Histological osteomyelitis in 9/28 bones; pressure-related changes in 14/28.

Related Experiment Videos

Roentgenograms suggested osteomyelitis in 4 confirmed cases.

Bone scans were sensitive (100% for osteomyelitis) but lacked specificity.

Bone cultures often revealed anaerobic bacteria or gram-negative bacilli.

Conclusions:

Osteomyelitis should be suspected if pressure sores are unresponsive to treatment.
Histological bone examination is the gold standard for diagnosing osteomyelitis.
Imaging (bone scans, X-rays) can be suggestive but not definitive.
Antibacterial therapy must be guided by bone culture results.