{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T23:52:52Z","timestamp":1772754772360,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,4,23]],"date-time":"2023-04-23T00:00:00Z","timestamp":1682208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Osteomyelitis (OM) remains one of the most feared complications in bone surgery and trauma. Its diagnosis remains a major challenge due to lack of guidelines. The aim of this study was to prospectively analyze the value of the most common and available diagnostic tools and to establish an OM score to derive treatment recommendations. All patients with suspected OM were included in a prospective pilot study. All patients underwent blood sampling for C-reactive protein and white blood cell count analysis. Magnetic resonance imaging (MRI), and microbiologic and histopathologic samples, were taken from representative sites of initial debridement. All patients were treated according to their OM test results and followed for at least one year. Subsequently, the value of individual or combined diagnostic tools was analyzed in patients with confirmed OM and in patients in whom OM was ruled out. Based on these findings, an OM score was developed that included MRI, microbiology, and histopathology. The score identified all control patients and all but one OM patient, resulting in a correct diagnosis of 93.3%, which was validated in a second independent larger cohort. This was the first study to analyze the value of the most commonly used tools to diagnose OM. The proposed OM score provides a simple scoring system to safely interpret test results with high accuracy.<\/jats:p>","DOI":"10.3390\/jcm12093057","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T02:31:05Z","timestamp":1682303465000},"page":"3057","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Value of Diagnostic Tools in the Diagnosis of Osteomyelitis: Pilot Study to Establish an Osteomyelitis Score"],"prefix":"10.3390","volume":"12","author":[{"given":"Roslind K.","family":"Hackenberg","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany"},{"name":"Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Schmitt-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5571-5527","authenticated-orcid":false,"given":"Christoph","family":"Endler","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Verena","family":"Tischler","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayagopi","family":"Surendar","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristian","family":"Welle","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1458-2825","authenticated-orcid":false,"given":"Koroush","family":"Kabir","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0797-1945","authenticated-orcid":false,"given":"Frank A.","family":"Schildberg","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S0140-6736(04)16727-5","article-title":"Osteomyelitis","volume":"364","author":"Lew","year":"2004","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.mporth.2010.09.004","article-title":"(iv) Osteomyelitis","volume":"24","author":"McNally","year":"2010","journal-title":"Orthop. 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