VA morning report 2.14 – Osteomyelitis

Case summary

Thanks to Sara and Renee for presenting a fascinating case of a 68F who presenting with weakness and found to have vertebral osteomyelitis, biopsy is pending.

Top pearls

  1. Patients with lower (thoracic, lumbar) vertebral disease (e.g., fracture, osteomyelitis) have a tough time sitting up due to the axial load this places on the spine.
  2. Vertebral tenderness to palpation is a highly insensitive sign for pathologic diseasesof the spine.
  3. The role of inflammatory markers (ESR, CRP) is for their negative predictive value in inflammatory/infectious/malignant causes of spinal disease (osteomyelitis, epidural abscess)
  4. Unlike osteomyelitis of the extremities, osteomyelitis of the spine is usually (1) hematogenous and (2) monomicrobial

Osteomyelitis Microbiology

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