Investigations

During a flare-up of chronic osteomyelitis there may or may not be leucocytosis and elevation of ESR and CRP. The CRP level correlates with clinical response to therapy and may be used to monitor treatment. Blood cultures may be positive, especially in hematogenous osteomyelitis involving the vertebrae, clavicle, or pubis.

Discharging pus should be cultured to determine the organisms and their sensitivity.

Reference

1. Glaudemans AWJM et al. Consensus document for the diagnosis of peripheral bone infection in adults: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement). Eur J Nucl Med Mol Imaging. 2019 Apr;46(4):957-70.