A 45-year-old patient presents to the emergency department with a history of diabetes mellitus and recent foot ulcer. The patient complains of increased pain, redness and swelling in the proximal left lower limb. Which of the following would be the BEST initial step in the management of suspected osteomyelitis?
Obtaining appropriate imaging studies, such as an MRI, is essential to confirm the diagnosis of osteomyelitis, especially in a case where the clinical presentation is suggestive but not definitive. MRI is particularly useful in assessing the extent of an infection and is more sensitive than X-rays for early changes of osteomyelitis. Initiation of broad-spectrum antibiotics, although important, should follow the conformation or strong suspicion based on imaging results. Blood culture results are valuable primarily when bacteremia is suspected and typically do not substitute for imaging in initial osteomyelitis diagnosis. NSAIDs are primarily for pain management and have no role in treating the underlying infection.
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Why is MRI preferred over X-rays for diagnosing osteomyelitis?
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What makes empiric antibiotics inappropriate before imaging in suspected osteomyelitis?
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BCEN CEN
Musculoskeletal and Wound Emergencies
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