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Genetic and Rare Diseases Information Center (GARD)

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Your Question

I have had pain in my right buttock and hip/spine for 3 years. I have had a few medical opinions regarding the cause. How is osteomyelitis diagnosed? Can if be identified through MRI or X-ray? 

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is osteomyelitis?

Osteomyelitis is the medical term for an infection in a bone.[1] The infection that causes osteomyelitis often is in another part of the body and spreads to the bone via the blood. Affected bone may have been predisposed to infection because of recent trauma. In children, the long bones are usually affected. In adults, the vertebrae and the pelvis are most commonly affected. Bone infection can be caused by bacteria or by fungus.[2] Osteomyelitis is divided into several types depending on where an infection begins and where it occurs. Types of osteomyelitis include: infections that travel through the bloodstream, infections that occur after injury or surgery, infections in people with poor circulation, and infection in the bones of the spine.[1]
Last updated: 7/28/2011

How is osteomyelitis diagnosed?

A physical examination shows bone tenderness and possibly swelling and redness.[2] Your doctor may order a combination of tests and procedures to diagnose osteomyelitis and to determine which germ is causing the infection.[1]

Tests may include:[2]

Last updated: 9/28/2010

Can osteomyelitis be diagnosed through X-ray or MRI?

Both X-rays and MRI can be helpful in diagnosing osteomyelitis. X-rays can reveal damage to your bone. However, damage may not be visible until osteomyelitis has been present for several weeks. More detailed imaging tests may be necessary if your osteomyelitis has developed more recently. A CT scan combines X-ray images taken from many different angles, creating detailed cross-sectional views of a person's internal structures. MRIs can produce exceptionally detailed images of bones and the soft tissues that surround them.[1]
Last updated: 9/28/2010

Is there a definitive test used to diagnose osteomyelitis?

A bone biopsy is the gold standard for diagnosing osteomyelitis because it not only identifies an infection, but can also reveal what particular type of germ has infected the bone. Knowing the type of germ allows your doctor to choose an antibiotic that works particularly well for that type of infection. There are two different types of bone biopsy. An open biopsy requires anesthesia and surgery to access the bone. In some situations, a surgeon inserts a long needle through the skin and into the bone to take a biopsy. This procedure requires local anesthetics to numb the area where the needle is inserted.[1]
Last updated: 9/28/2010

See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.