title: Trends in the epidemiology of osteomyelitis: a population-based study, 1969 to 2009.
abstract: BACKGROUND
  The epidemiology of osteomyelitis in the United States is largely unknown. The purpose of this study was to determine long-term secular trends in the incidence of osteomyelitis in a population-based setting.
  
  
  METHODS
  The study population comprised 760 incident cases of osteomyelitis first diagnosed between January 1, 1969, and December 31, 2009, among residents of Olmsted County, Minnesota. The complete medical records for each potential subject were reviewed to confirm the osteomyelitis diagnosis and to extract details on anatomical sites, infecting organisms, etiological risk factors, and outcomes.
  
  
  RESULTS
  The overall age and sex-adjusted annual incidence of osteomyelitis was 21.8 cases per 100,000 person-years. The annual incidence was higher for men than for women and increased with age (p < 0.001). Rates increased with the calendar year (p < 0.001) from 11.4 cases per 100,000 person-years in the period from 1969 to 1979 to 24.4 per 100,000 person-years in the period from 2000 to 2009. The incidence remained relatively stable among children and young adults but almost tripled among individuals older than sixty years; this was partly driven by a significant increase in diabetes-related osteomyelitis from 2.3 cases per 100,000 person-years in the period from 1969 to 1979 to 7.6 cases per 100,000 person-years in the period from 2000 to 2009 (p < 0.001). Forty-four percent of cases involved Staphylococcus aureus infections.
  
  
  CONCLUSIONS
  The reasons for the increase in osteomyelitis between 1969 and 2009 are unclear but could comprise a variety of factors, including changes in diagnosing patterns or increases in the prevalence of risk factors (e.g., diabetes) in this population.
authors.affiliation: Departments of Health Sciences Research (H.M.K., J.E.R., C.M.W.-W., and L.J.M.) and Orthopedic Surgery (P.M.H.), Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for H.M. Kremers: maradit@mayo.edu.
authors.forename: Hilal Maradit
authors.initials: HM
authors.lastname: Kremers
authors.affiliation: Dignity Health St. Joseph's Hospital and Medical Center, 300 West Thomas Road, Phoenix, AZ 85013.
authors.forename: Macaulay E
authors.initials: ME
authors.lastname: Nwojo
authors.affiliation: Departments of Health Sciences Research (H.M.K., J.E.R., C.M.W.-W., and L.J.M.) and Orthopedic Surgery (P.M.H.), Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for H.M. Kremers: maradit@mayo.edu.
authors.forename: Jeanine E
authors.initials: JE
authors.lastname: Ransom
authors.affiliation: Departments of Health Sciences Research (H.M.K., J.E.R., C.M.W.-W., and L.J.M.) and Orthopedic Surgery (P.M.H.), Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for H.M. Kremers: maradit@mayo.edu.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Wood-Wentz
authors.affiliation: Departments of Health Sciences Research (H.M.K., J.E.R., C.M.W.-W., and L.J.M.) and Orthopedic Surgery (P.M.H.), Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for H.M. Kremers: maradit@mayo.edu.
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Melton
authors.affiliation: Departments of Health Sciences Research (H.M.K., J.E.R., C.M.W.-W., and L.J.M.) and Orthopedic Surgery (P.M.H.), Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for H.M. Kremers: maradit@mayo.edu.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Huddleston
mesh_terms: D000328:Adult; D017677:Age Distribution; D000671:Amputation, Surgical / Q000401:mortality / Q000706:statistics & numerical data / Q000639:trends; D015331:Cohort Studies; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000401:mortality; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D010019:Osteomyelitis / Q000453:epidemiology* / Q000401:mortality; D063507:Sexism