Your Path

  • Osteomyelitis


  • In adult, most commonly occurs in distal extremity


  • Staph
  • Strep
  • DM and chronic wounds→ GNRs and mixed flora
  • Mycobact→ from endemic area and compromised
  • Cocci or other fungal→ endemic area and/or compromised

Risk Factors

  • Trauma
  • Wounds
  • Dm
  • Assoc w/neuropathy and peripheral arterial dz
  • Can also be from traumatic innoculation of bacteria
  • Also bacteremia→ more common in kids
  • Immuno-compromised


  • If from pad/dm→ typically distal ulcer or sinus tract, non-healing, pain
  • If traumatic, then suggestive hx, open wound or draining sinus
  • Fungal/mycobact→ sub-acute, progressive

Physical Exam Findings

  • Pain
  • Swelling
  • Redness non-healing ulcer
  • Visible bone and/or probe to bone→ clinical osteomyelitis