[4] Risks for developing osteomyelitis include diabetes, intravenous drug use, prior removal of the spleen, and trauma to the area.

[1] Diagnosis is typically suspected based on symptoms and basic laboratory tests as C-reactive protein and erythrocyte sedimentation rate.

[10] Symptoms may include pain in a specific bone with overlying redness, fever, and weakness and inability to walk especially in children with acute bacterial osteomyelitis.

[8] Acute osteomyelitis almost invariably occurs in children who are otherwise healthy, because of rich blood supply to the growing bones.

[7] The most commonly affected areas for children are the long bones,[7][failed verification] and for adults, the feet, spine, and hips.

[15] The most common form of the disease in adults is caused by injury exposing the bone to local infection.

Tubercular osteomyelitis of the spine was so common before the initiation of effective antitubercular therapy, it acquired a special name, Pott's disease.

[citation needed] The Burkholderia cepacia complex has been implicated in vertebral osteomyelitis in intravenous drug users.

[21] These combined factors may explain the chronicity and difficult eradication of this disease, resulting in significant costs and disability, potentially leading to amputation.

In children, large subperiosteal abscesses can form because the periosteum is loosely attached to the surface of the bone.

[13] Because of the particulars of their blood supply, the tibia, femur, humerus, vertebrae, maxilla and the mandibular bodies are especially susceptible to osteomyelitis.

Many infections are caused by Staphylococcus aureus, a member of the normal flora found on the skin and mucous membranes.

[25] Nuclear medicine scans can be a helpful adjunct to MRI in patients who have metallic hardware that limits or prevents effective magnetic resonance.

[13] Culture of material taken from a bone biopsy is needed to identify the specific pathogen;[27] alternative sampling methods such as needle puncture or surface swabs are easier to perform, but cannot be trusted to produce reliable results.

Traditionally, the length of time the infection has been present and whether there is suppuration (pus formation) or osteosclerosis (pathological increased density of bone) are used to arbitrarily classify OM.

Some studies of children with acute osteomyelitis report that antibiotic by mouth may be justified due to PICC-related complications.

[32][33] Due to insufficient evidence it is unclear what the best antibiotic treatment is for osteomyelitis in people with sickle cell disease as of 2019.

[34] Initial first-line antibiotic choice is determined by the patient's history and regional differences in common infective organisms.

[38] Before the widespread availability and use of antibiotics, blow fly larvae were sometimes deliberately introduced to the wounds to feed on the infected material, effectively scouring them clean.

[42] Hemicorporectomy is performed in severe cases of Terminal Osteomyelitis in the Pelvis if further treatment won't stop the infection.

In 1875, American artist Thomas Eakins depicted a surgical procedure for osteomyelitis at Jefferson Medical College, in an oil painting titled The Gross Clinic.

"[46] Evidence for osteomyelitis found in the fossil record is studied by paleopathologists, specialists in ancient disease and injury.