Differentials
| Septic Arthritis | Especially if pain is focused around a joint or if patient can’t bend a joint. Usually, a lot more painful and cannot weight bear at all. See the lecture!! |
| Osteosarcoma | Doesn’t tend to present as acutely as osteomyelitis but important to consider especially if the patient has B-symptoms |
| Abcess | Important to consider especially in those with IVDU, the erythema tends to be quite localised and there is usually a fluidity to the swelling. |
| Fracture non-union | Less likely to be a feasible differential however important to keep on your radar |
| Haematoma | More likely after trauma, especially if infected |
| Cellulitis | Usually more superficial, responsive to abx |
These are your key differentials, septic arthritis again is the key one you really don't want to miss as missing this can absolutely cripple your patient.
Never let the sun rise and set on pus!
Osteosarcoma and non-union fractures are less likely to present as acutely as OM, however they are important differentials to think of and have 'on your radar' when assessing patients.
Haematomas and abscesses may present a lot like OM and indeed may overly an area of OM especially in your more chaotic and unhealthy patients generally and oftentimes both will need to be managed.
The main point of this is not to get blind-sided. Its easy to think of any of these things and ignore the rest based on a history which if you do may result in you missing what's going on. It's important to sometimes take a step back from the patient, have a breather and think about the other possibilities to be as comprehensive as possible.
