title: [Definition of the Diagnosis Osteomyelitis-Osteomyelitis Diagnosis Score (ODS)].
abstract: OBJECTIVE
  The disease "osteomyelitis" is characterised by different symptoms and parameters. Decisive roles in the development of the disease are played by the causative bacteria, the route of infection and the individual defense mechanisms of the host. The diagnosis is based on different symptoms and findings from the clinical history, clinical symptoms, laboratory results, diagnostic imaging, microbiological and histopathological analyses. While different osteomyelitis classifications have been published, there is to the best of our knowledge no score that gives information how sure the diagnosis "osteomyelitis" is in general.
  
  
  METHODS
  For any scientific study of a disease a valid definition is essential. We have developed a special osteomyelitis diagnosis score for the reliable classification of clinical, laboratory and technical findings. The score is based on five diagnostic procedures: 1) clinical history and risk factors, 2) clinical examination and laboratory results, 3) diagnostic imaging (ultrasound, radiology, CT, MRI, nuclear medicine and hybrid methods), 4) microbiology, and 5) histopathology.
  
  
  RESULTS
  Each diagnostic procedure is related to many individual findings, which are weighted by a score system, in order to achieve a relevant value for each assessment. If the sum of the five diagnostic criteria is 18 or more points, the diagnosis of osteomyelitis can be viewed as "safe" (diagnosis class A). Between 8-17 points the diagnosis is "probable" (diagnosis class B). Less than 8 points means that the diagnosis is "possible, but unlikely" (class C diagnosis). Since each parameter can score six points at a maximum, a reliable diagnosis can only be achieved if at least 3 parameters are scored with 6 points.
  
  
  CONCLUSIONS
  The osteomyelitis diagnosis score should help to avoid the false description of a clinical presentation as "osteomyelitis". A safe diagnosis is essential for the aetiology, treatment and outcome studies of osteomyelitis.
authors.affiliation: Septische Knochen- und Weichteilchirurgie, Schön Klinik HH Eilbek, Dehnhaide 120, Hamburg. hergo.schmidt@arcor.de
authors.forename: H G K
authors.initials: HG
authors.lastname: Schmidt
authors.forename: A H
authors.initials: AH
authors.lastname: Tiemann
authors.forename: R
authors.initials: R
authors.lastname: Braunschweig
authors.forename: M
authors.initials: M
authors.lastname: Diefenbeck
authors.forename: M
authors.initials: M
authors.lastname: Bühler
authors.forename: D
authors.initials: D
authors.lastname: Abitzsch
authors.forename: N
authors.initials: N
authors.lastname: Haustedt
authors.forename: G
authors.initials: G
authors.lastname: Walter
authors.forename: R
authors.initials: R
authors.lastname: Schoop
authors.forename: V
authors.initials: V
authors.lastname: Heppert
authors.forename: G O
authors.initials: GO
authors.lastname: Hofmann
authors.forename: M
authors.initials: M
authors.lastname: Glombitza
authors.forename: C
authors.initials: C
authors.lastname: Grimme
authors.forename: U-J
authors.initials: UJ
authors.lastname: Gerlach
authors.forename: I
authors.initials: I
authors.lastname: Flesch
mesh_terms: D001431:Bacteriological Techniques; D001842:Bone and Bones / Q000473:pathology; D019411:Clinical Laboratory Techniques; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D010019:Osteomyelitis / Q000145:classification* / Q000175:diagnosis* / Q000473:pathology; D010808:Physical Examination; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity