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52: OSTEOMYELITIS

Eric Shamus, PhD, DPT, PT, CSCS; Shallen (McClain) Flory, DPT

CONDITION/DISORDER SYNONYMS

  • Bone infection

  • Pyogenic osteomyelitis

ICD-9-CM CODES

  • 730 Osteomyelitis periostitis and other infections involving bone

  • 730.0 Acute osteomyelitis

  • 730.00 Acute osteomyelitis, site unspecified

  • 730.01 Acute osteomyelitis, shoulder region

  • 730.02 Acute osteomyelitis, upper arm

  • 730.03 Acute osteomyelitis, forearm

  • 730.04 Acute osteomyelitis, hand

  • 730.05 Acute osteomyelitis, pelvic region and thigh

  • 730.06 Acute osteomyelitis, lower leg

  • 730.07 Acute osteomyelitis, ankle and foot

  • 730.08 Acute osteomyelitis, other specified sites

  • 730.09 Acute osteomyelitis, multiple sites

  • 730.1 Chronic osteomyelitis

  • 730.10 Chronic osteomyelitis, site unspecified

  • 730.11 Chronic osteomyelitis, shoulder region

  • 730.12 Chronic osteomyelitis, upper arm

  • 730.13 Chronic osteomyelitis, forearm

  • 730.14 Chronic osteomyelitis, hand

  • 730.15 Chronic osteomyelitis, pelvic region and thigh

  • 730.16 Chronic osteomyelitis, lower leg

  • 730.17 Chronic osteomyelitis, ankle and foot

  • 730.18 Chronic osteomyelitis, other specified sites

  • 730.19 Chronic osteomyelitis, multiple sites

  • 730.2 Unspecified osteomyelitis

  • 730.20 Unspecified osteomyelitis, site unspecified

  • 730.21 Unspecified osteomyelitis, shoulder region

  • 730.22 Unspecified osteomyelitis, upper arm

  • 730.23 Unspecified osteomyelitis, forearm

  • 730.24 Unspecified osteomyelitis, hand

  • 730.25 Unspecified osteomyelitis, pelvic region and thigh

  • 730.26 Unspecified osteomyelitis, lower leg

  • 730.27 Unspecified osteomyelitis, ankle and foot

  • 730.28 Unspecified osteomyelitis, other specified sites

  • 730.29 Unspecified osteomyelitis, multiple sites

  • 730.3 Periostitis without mention of osteomyelitis

  • 730.30 Periostitis, without mention of osteomyelitis, site unspecified

  • 730.31 Periostitis, without mention of osteomyelitis, shoulder region

  • 730.32 Periostitis, without mention of osteomyelitis, upper arm

  • 730.33 Periostitis, without mention of osteomyelitis, forearm

  • 730.34 Periostitis, without mention of osteomyelitis, hand

  • 730.35 Periostitis, without mention of osteomyelitis, pelvic region and thigh

  • 730.36 Periostitis, without mention of osteomyelitis, lower leg

  • 730.37 Periostitis, without mention of osteomyelitis, ankle and foot

  • 730.38 Periostitis, without mention of osteomyelitis, other specified sites

  • 730.39 Periostitis, without mention of osteomyelitis, multiple sites

FIGURE 52-1

A. Standard radiology image indicates infection with sclerosis of the proximal tibia and periosteal elevation and obvious bone destruction with an apparent cavity and the suggestion of a sequestrum in the proximal medial tibia. B and C. Magnetic resonance images more clearly visualize the bone and soft tissue anatomy, confirming an extensive infection with destruction within the proximal tibia that has extended into the surrounding soft tissues and the joint as well as a ring of calcification most consistent with an abscess. D. A longitudinal MRI shows the extent of longitudinal bone destruction and soft tissue involvement with contrast enhancement that suggests viable marrow from the middle to the distal tibial shaft. (From Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison’s Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2012.)

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FIGURE 52-2

Acute osteomyelitis. The primary site of infection is usually in the metaphysial region, from which the infection may spread to involve the cortex and form a subperiosteal abscess; may spread into the medullary cavity; or, rarely, may spread into the adjacent joint space. (From Chandrasoma P, Taylor CR. Concise Pathology. 3rd ed. www.accessmedicine.com. Copyright © ...

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