Diagnosis of vertebral osteomyelitis

Native vertebral osteomyelitis (NVO) is a potentially fatal infection whichhas seen a gradual increase in its incidence over the past decades. Theinfection is insidious, presenting with symptoms of back pain. Fever ispresent in about 60 % of patients. Prompt diagnosis of NVO is important toprevent the development of complications. Numerous laboratory and imagingtools can be deployed to accurately establish the diagnosis. Imagingtechniques such as magnetic resonance, nuclear imaging, and computedtomography are essential in diagnosing NVO but can also be useful inimage-guided biopsies. Laboratory tools include routine blood tests,inflammatory markers, and routine culture techniques of aspirated specimens.Recent advances in molecular techniques can assist in identifying offendingpathogen(s). In this review, we detail the arsenal of techniques that can beutilized to reach a diagnosis of NVO.