Orthopedics Book


Acute Osteomyelitis

Aka: Acute Osteomyelitis, Osteomyelitis in Children, Pediatric Osteomyelitis, Acute Hematogenous Osteomyelitis
  1. See Also
    1. Osteomyelitis
    2. Osteomyelitis Causes
    3. Chronic Osteomyelitis
    4. Pediatric Limp
    5. Vertebral Osteomyelitis
  2. Epidemiology
    1. More common in boys
  3. Pathophysiology
    1. Inflammatory bone changes associated with pathogenic Bacteria (often monomicrobial)
      1. Staphylococcus aureus is most common cause in Pediatric Osteomyelitis
    2. Typically acute hematogenous spread to Traumatized bone
      1. Most common in children under age 5 (50% of cases)
      2. Most commonly affects the highly vascular metaphyses of long bone
  4. Symptoms
    1. Presentation within two weeks of symptom onset
    2. Fever
    3. Irritability or lethargy
  5. Signs
    1. Systemic signs of infection
    2. Local signs of infection
      1. Tenderness on palpation over involved bone
      2. Localized inflammation with erythema and swelling
      3. Decreased range of motion of adjacent joints
    3. Distribution
      1. Femur, tibia or fibula
        1. Account for 50% of Osteomyelitis cases in prepubertal children
        2. May present with Pediatric Limp
      2. Vertebral Osteomyelitis
        1. Most common form of hematogenous Osteomyelitis, especially in older children or adults
        2. Presents with severe neck or back pain, Muscle tenderness and reduced range of motion
      3. Other sites
        1. Sternoclavicular Bone
        2. Pelvic Bone
        3. Other long bones
  6. Causes
    1. See Osteomyelitis Causes
  7. Differential Diagnosis
    1. See Osteomyelitis
  8. Labs
    1. See Osteomyelitis
    2. ESR and CRP may be early indicators of Osteomyelitis (albeit non-specific)
  9. Imaging
    1. See Osteomyelitis
    2. XRays are often normal for first 2-3 weeks
  10. Diagnosis
    1. See Osteomyelitis
  11. Management
    1. See Osteomyelitis Management
  12. References
    1. Jhun and Raam in Herbert (2016) EM:Rap 16(2):15-6
    2. Hatzenbuehler (2011) Am Fam Physician 84(9): 1027-33 [PubMed]
    3. Boutin (1998) Orthop Clin North Am 29:41-66 [PubMed]
    4. Bury (2021) Am Fam Physician 104(4): 395-402 [PubMed]
    5. Carek (2001) Am Fam Physician 63(12):2413-20 [PubMed]
    6. Dirschl (1993) Drugs 45:29-43 [PubMed]
    7. Eckman (1995) JAMA 273:712-20 [PubMed]
    8. Haas (1996) Am J Med 101:550-61 [PubMed]
    9. Lew (1997) N Engl J Med 336:999-1007 [PubMed]
    10. Lipsky (1997) Clin Infect Dis 25:1318-26 [PubMed]

Acute osteomyelitis (C0158371)

Concepts Disease or Syndrome (T047)
ICD9 730.00, 730.0
SnomedCT 203180000, 68231009, 156790002, 203146003, 203147007, 156781009, 409780002
English Acute osteomyelitis NOS, Acute osteomyelitis of unspecified site, Acute osteomyelitis, site unspecified, Acute osteomyelitis-site unsp., acute osteomyelitis (diagnosis), acute osteomyelitis, osteomyelitis acute, Osteomyelitis acute NOS, Ac osteomyelitis-unspec, bone abscess, Osteomyelitis;acute, abscess bone, Acute osteomyelitis, Acute osteomyelitis NOS (disorder), Acute osteomyelitis of unspecified site (disorder), Osteomyelitis acute, acute; osteomyelitis, osteomyelitis; acute, Acute osteomyelitis with or without periostitis, Acute osteomyelitis, NOS, Acute osteomyelitis (disorder), Acute or subacute osteomyelitis with or without mention of periostitis
Italian Osteomielite acuta, Osteomielite acuta, sede non specificata, Osteomielite acuta NAS
Dutch acute osteomyelitis, plaats niet-gespecificeerd, acute osteomyelitis, osteomyelitis acuut NAO, acuut; osteomyelitis, osteomyelitis; acuut, osteomyelitis acuut
French Ostéomyélite aiguë, site non précisé, Ostéomyélite aiguë SAI, Ostéomyélite aiguë
German akute Osteomyelitis, Stelle unspezifisch, Osteomyelitis akut NNB, akute Osteomyelitis
Portuguese Osteomielite aguda NE, Osteomielite aguda de localização NE, Osteomielite aguda
Spanish Osteomielitis aguda NEOM, Osteomielitis aguda, localización no especificada, osteomielitis aguda, de sitio no especificado, osteomielitis aguda, SAI (trastorno), Acute osteomyelitis NOS, osteomielitis aguda, de localización no especificada, osteomielitis aguda, SAI, osteomielitis aguda, de localización no especificada (trastorno), osteomielitis aguda, de sitio no especificado (trastorno), Osteomielitis aguda, osteomielitis aguda (trastorno), osteomielitis aguda
Japanese 急性骨髄炎、部位不明, 急性骨髄炎, 急性骨髄炎NOS, キュウセイコツズイエン, キュウセイコツズイエンNOS, キュウセイコツズイエンブイフメイ
Czech Akutní osteomyelitida, Akutní osteomyelitida NOS, Akutní osteomyelitida postihující blíže neurčenou část těla
Hungarian acut osteomyelitis k.m.n., acut osteomyelitis, Acut osteomyelitis, Acut osteomyelitis, nem meghatározott helyen
Derived from the NIH UMLS (Unified Medical Language System)

Acute hematogenous osteomyelitis (C0600123)

Concepts Disease or Syndrome (T047)
ICD10 M86.0, M86.00, M86.09
SnomedCT 203179003
English Acute haematogen osteomyelitis, Acute hematogenous osteomyelitis, unspecified site, Acute haematogenous osteomyelitis, site unspecified, Acute hematogenous osteomyelitis, site unspecified, acute hematogenous osteomyelitis, osteomyelitis acute hematogenous, acute hematogenous osteomyelitis (diagnosis), Acute haematogenous osteomyelitis, Acute hematogenous osteomyelitis, Acute hematogenous osteomyelitis (disorder), osteomyelitis; acute, hematogenous
German Akute haematogene Osteomyelitis
Korean 급성 혈행성 골수염
Spanish osteomielitis hematógena aguda, osteomileitis hematógena aguda, osteomielitis hematógena aguda (trastorno), osteomileitis hematógena aguda (trastorno)
Dutch osteomyelitis; acuut, hematogeen, Acute hematogene osteomyelitis
Derived from the NIH UMLS (Unified Medical Language System)

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