Diagnosing osteomyelitis

If you have a high temperature and bone pain, you should visit your GP for a diagnosis.

Physical examination

To confirm a diagnosis of suspected osteomyelitis, your GP will first carry out a physical examination of your affected body part to check for redness, swelling and tenderness.

They will want to know your recent medical history, such as whether you have recently had an injury, surgery or a previous infection.

If your GP is unsure about a diagnosis, or suspects osteomyelitis, they may refer you to an orthopaedic surgeon (a specialist in bones and joints).

Blood test

You may be referred for a blood test. This cannot confirm osteomyelitis, but can indicate whether you have a high number of white blood cells in your blood, which may suggest you have an infection. Also, if the osteomyelitis was caused by bacteria spreading in your blood, a blood test may be useful for detecting the bacteria.

Imaging tests

If osteomyelitis is suspected, it is likely you will be referred for further imaging testing. There are several imaging tests that may be able to detect bone damage caused by osteomyelitis. They include:

• X-rays, where low levels of radiation are used to create an image of the affected bone – this test is not usually useful for diagnosis if the condition is in the early stages.
• magnetic resonance imaging (MRI) scan, where a strong magnetic field and radio waves are used to build up a picture of the inside of the affected bone
• computerised tomography (CT) scan, where a series of X-rays of your affected bone are taken and a computer is used to assemble them into a more detailed three-dimensional image
• ultrasound scan, where high-frequency sound waves are used to create an image of the affected bone to highlight any abnormalities

Biopsy

If earlier testing suggests osteomyelitis, it is usually necessary to remove a small sample of bone for further testing. This is known as a biopsy.

A biopsy is usually necessary to confirm a diagnosis of osteomyelitis and can help establish the exact type of bacteria or fungus causing your infection. This can be very useful when deciding on the most effective treatment.

A biopsy is usually combined with surgery in chronic cases.

If you have a wound producing pus, a sample of this may also be taken for further testing.