Acute Osteomyelitis in Adults

Hematogenous osteomyelitis involves long bones in children, but predominantly the vertebral column in adults. According to a large series of hematogenous osteomyelitis reported by Jensen et al., the median age of patients with vertebral osteomyelitis is 65 years, as compared to 16 years in patients with other types of osteomyelitis. This chapter focuses on acute vertebral osteomyelitis, also termed spinal osteomyelitis, spondylodiskitis, septic diskitis, or disk-space infection. Imaging procedures are the most important tools to diagnose osteomyelitis and rule out other diseases, such as bone metastases or osteoporotic fractures. They allow precisely localizing the infection and looking for pyogenic complications. The aims of therapy are (i) relief of back pain; (ii) elimination of the microorganisms; (iii) protection from further bone loss; (iv) prevention of complications; (v) evacuation of purulent collections; and (vi) stabilization, if needed. In most cases of acute osteomyelitis, surgical treatment is not required.