What is the role of osteomyelitis in the progression of pressure injuries (pressure ulcers)?

Updated: Mar 26, 2020
  • Author: Christian N Kirman, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Sepsis also can occur secondary to osteomyelitis, which has been reported to occur in 26% of nonhealing ulcers. [8] A prospective study demonstrated that osteomyelitis was associated with nonhealing grade 4 pressure injuries in 86% of the study population. [60, 61] This study utilized three-phase technetium methyl diphosphate radionuclide flow to detect early osteomyelitis.

Various tests can be used to diagnose osteomyelitis in patients with pressure injuries. Plain radiographs have a sensitivity of 78% and a specificity of 50%, but radiographic findings often are not present in the early stages of infection. Bone scans are more sensitive, but their specificity is low (50%). Bone biopsy has the highest specificity (96%) and sensitivity (73%). [60, 61]

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