Osteomyelitis
Haematogenous, contiguous and chronic osteomyelitis; MRI as the imaging test; when blood cultures are enough and when you need a bone biopsy before antibiotics; 6 weeks for vertebral infection; early oral switch (OVIVA); and when surgery is needed.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Osteomyelitis reaches bone by the blood, from a contiguous focus (diabetic foot, pressure injury, open fracture, surgery), or through vascular insufficiency.
- S. aureus causes most haematogenous and many contiguous infections.
- MRI is the best imaging test. Plain films lag 2 weeks.
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Sources
- Therapeutic Guidelines: Antibiotic. Bone and joint infections (osteomyelitis)AU/NZTherapeutic Guidelines Limited (eTG complete), 2025 to 2026 staged update; guideline-wide changes March 2025 (topic version not verified)
- Berbari EF et al. 2015 IDSA clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis 2015;61:e26-46Infectious Diseases Society of America, 2015 (current; no later update found November 2026)
- Senneville E et al. IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF/IDSA 2023). Clin Infect Dis 2023International Working Group on the Diabetic Foot and Infectious Diseases Society of America, 2023
- Bernard L et al. Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial. Lancet 2015;385:875-82The Lancet, 2015
- Park KH et al. Optimal duration of antibiotic therapy in patients with hematogenous vertebral osteomyelitis at low risk and high risk of recurrence. Clin Infect Dis 2016;62:1262-9Clinical Infectious Diseases, 2016
- Li HK et al. Oral versus intravenous antibiotics for bone and joint infection (OVIVA). N Engl J Med 2019;380:425-36New England Journal of Medicine, 2019
- Pourghazi F et al. Integrating molecular and conventional diagnostics in native vertebral osteomyelitis: a narrative review. J Bone Jt Infect 2026;11:373-85Journal of Bone and Joint Infection, 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Deploy to Cloudflare on push to main