This page is dedicated to organizing various examples of standardized exam questions whose answer is osteomyelitis. While this may seem a odd practice, it is useful to see multiple examples of how osteomyelitis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each topic has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for osteomyelitis.
- Recent history of infection: bacteremia,
- Fever is often an important clue that is present that points to an infectious process
- Bone pain can be present (such as point tenderness)
- Bone lesions on imaging studies
Question # 1
A 17 year old boy who plays foot ball has a sudden onset of fever, fatigue, as well as pain in his right lower leg. He is no longer able to walk because of the pain and appears to be acutely ill. His temperature is 103.3°F. Upon examination he has limited movement of his right leg, and there is swelling and point tenderness over the proximal, medial lower leg. The skin around the tenderness seems intact and there is no sign of trauma. His labs are as follows:
- Hemoglobin: 12.5 g/dL
- Leukocyte count: 15,000/mm³**
- ESR: 65 mm/h**
A technetium bone scan is conducted and shows increased uptake at the metaphysics of the tibia. What is the most likely diagnosis?
Explanation # 1
Bone pain + fever + no signs of trauma + increased white count + increased ESR + bone scan with increased uptake = osteomyelitis
Page Updated: 11.19.2016