Summary
Definition
History and exam
Key diagnostic factors
- nonspecific 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
Investigations to consider
- sinus-tract cultures
- MRI of bone
- CT of joint
- radionuclide scans
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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