How is osteomyelitis typically diagnosed?

Osteomyelitis is typically diagnosed through a combination of clinical assessment and imaging studies, with plain x-rays serving as a common initial diagnostic tool. X-rays can reveal changes in the bones, such as bone erosion or the presence of sequestra (areas of dead bone), which may indicate infection. Although x-rays may not show early changes within the first few days of infection, they are useful in assessing chronic cases where bone alterations become more apparent over time.

While other imaging modalities like MRI or CT scans can provide detailed visualization and help confirm the diagnosis by better assessing the extent of the infection and identifying associated complications, they are often used after initial plain x-ray findings or when further detail is necessary. Bone biopsy is an invasive procedure that can provide a definitive diagnosis by yielding culture and histological data, but it is typically not the first line of diagnosis. Rather, it is reserved for cases where imaging and clinical findings suggest osteomyelitis but without conclusive evidence.