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Osteomyelitis A048

Last amended 
16 May 2019
Current RMA Instruments

Reasonable Hypothesis SOP

90 of 2014

Balance of Probabilities SOP

91 of 2014

Changes from previous Instruments

SOP Bulletin 178

ICD Coding
  • ICD-9-CM Codes: 730.00-.29, 730.80-.89, 730.90-.99, 526.4

  • ICD-10-AM Codes: M86, K10.2, M46.2, M90.2

Brief description

This is an infection involving bone. The infection is usually from a bacterium, a mycobacterium or a fungi and may be acute or chronic. Infection occurs as a result of direct infection of the bone through a skin penetration or via blood borne spread from another bodily source of infection.

Confirming the diagnosis

A diagnosis of osteomyelitis is generally established via culture obtained from biopsy of the involved bone.  The diagnosis may also be made based on clinical and radiological findings and positive blood cultures for a likely pathogen.  The diagnosis will sometimes be made in the absence of positive bone or blood cultures if the clinical picture and other investigative findings are indicative.

The appropriate medical specialist is an infectious diseases physician or othropaedic surgeon.

Additional diagnoses covered by SOP
  • Brodie abscess
Conditions excluded from SOP
  • Isolated septic arthritis#
  • Myelitis#
  • Osteomalacia#
  • Osteonecrosis#
  • Osteopaenia, declared not a disease by RMA - NIF
  • Osteoporosis*

* another SOP applies

# non-SOP condition

Clinical onset

The condition may present in a variety of ways depending on the underlying cause, associated conditions and whether the condition is acute or chronic.  Symptoms may include dull pain at the site along with tenderness, redness and swelling.  There may be preceding trauma or a non-healing skin ulcer.  Chronic osteomyelitis may also present as a non-healing fracture.

Clinical worsening

The course of the condition is variable.  Generally good outcomes occur with acute osteomyelitis, but less favourable outcomes may occur with chronic disease. Surgical debridement and antibiotic therapy is generally required and some patients may go on to need amputations.