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Osteomyelitis - Cellulitis DDx
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Osteomyelitis - Cellulitis DDx

See also in: Skin
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Contributors: Tara Mahar MD, Art Papier MD
Other Resources UpToDate PubMed

Synopsis

Osteomyelitis is an inflammatory process of bone secondary to an infection, often bacterial. Osteomyelitis can be caused by contiguous spread of infection from adjacent soft tissues and joints, hematogenous seeding, or direct inoculation of microorganism(s) into the bone as a result of trauma or surgery. Signs and symptoms include fever, malaise, tenderness, and decreased range of motion. Staphylococcus aureus is the most common microorganism recovered in cases of osteomyelitis, but streptococci, Pseudomonas, Haemophilus influenzae, and Enterobacter species are also frequently encountered. Fungal organisms such as Coccidioides and mycobacteria can be causes of osteomyelitis.

Osteomyelitis can complicate ulcers, especially diabetic foot ulcers and decubitus ulcers. Risk factors for osteomyelitis include intravenous drug abuse, immunosuppression, prostheses, trauma, rheumatoid arthritis, diabetes mellitus, and alcohol use disorder. Often in cases of osteomyelitis, the skin overlying the infected bone is erythematous and edematous, simulating primary cellulitis. True complicating cellulitis may also be present. Ulcers and draining sinuses may be observed in cases of chronic osteomyelitis.

Osteomyelitis should be suspected in cases of apparent cellulitis overlying a joint, especially if there are musculoskeletal symptoms (stiffness, arthralgia) present.

Codes

ICD10CM:
M86.9 – Osteomyelitis, unspecified

SNOMEDCT:
60168000 – Osteomyelitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 11/03/2017
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Osteomyelitis - Cellulitis DDx
See also in: Skin
Print 3 Images
View all Images (3)
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Osteomyelitis : Fever, Painful skin lesions, Skin ulcer, Skin warm to touch, Tender skin lesions, Limited range of motion
Clinical image of Osteomyelitis
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