Last reviewed: November 2017
Last updated: March  2015

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • non-specific pain at site of infection
  • malaise and fatigue
  • local inflammation, erythema, or swelling
  • low-grade fever

Other diagnostic factors

  • wound drainage
  • scars, previous flaps
  • reduced range of movement
  • reduced sensation in diabetic foot ulcer
  • urinary tract symptoms
  • torticollis

Risk factors

  • penetrating injuries
  • surgical contamination
  • IV drug abuse
  • HIV
  • diabetes mellitus
  • periodontitis

Diagnostic investigations

1st investigations to order

  • WBC count
  • plain radiograph of affected area
  • blood cultures
  • ESR
  • CRP
  • cultures from aspiration of joint/abscess
  • cultures from bone after debridement
Full details

Investigations to consider

  • sinus-tract cultures
  • MRI of bone
  • CT of joint
  • radionuclide scans
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Department Chief

Musculoskeletal Sciences

Spectrum Health Medical Group

Grand Rapids

MI

Disclosures

JHC declares that he has no competing interests.

Clinical Professor of Medicine and Orthopedics

University of Pittsburgh Medical Center

Pittsburgh

PA

Disclosures

NR declares that she has no competing interests.

Research Assistant Professor

Department of Orthopedics

The Ohio State University

Columbus

OH

Disclosures

MMM declares that he has no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Infectious Diseases

Bayview Medical Center

Baltimore

MD

Disclosures

KJ declares that she has no competing interests.

Associate Professor

Department of Infectious Diseases

University of Naples

Naples

Italy

Disclosures

SE has been reimbursed for attending several conferences and received fees for speaking and running educational programs by Pfizer, Novartis, Wyeth Lederle, Sanofi Aventis, and GSK.

Professor of Medicine

Infectious Diseases Division

University of Connecticut Health Center

Hartford

CT

Disclosures

EP declares that he has no competing interests.

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