Osteomyelitis refers to infection of the bone, usually by bacteria. Typical features of this condition include the following:

• Intense and severe pain in the affected bone
• Fever, chills and shivering
• Tenderness and swelling of the affected area

If a physician suspects a patient may have osteomyelitis, they will take the following steps to confirm a diagnosis.

• The doctor asks about the patient’s recent medical history including any examples of injury, surgery or infection. They will also ask about any previous history of medical conditions that increase the likelihood of osteomyelitis such as diabetes or sickle cell anemia.
• A detailed physical examination is carried out to check the affected area for tenderness, swelling and redness.
• A blood test may be arranged to check whether the white blood cell count is elevated, as this may indicate infection. The blood sample can also be used to detect bacteria.
• Imaging studies carried out include X-ray, a magnetic resonance imaging (MRI) scan and a computerised tomography (CT) scan. X-ray is not usually effective for diagnosing early stage disease. An MRI scan allows visualization of the inside of the bone and a CT scan is used to build up a detailed 3D picture of the affected area.
• Biopsy – If a diagnosis of osteomyelitis looks likely, a small sample of the bone is taken in a procedure called a biopsy and sent for further testing. This indicates exactly what the infective agent is, so that the most suitable treatment can be chosen.