April 11, 1980

Vertebral osteomyelitis often goes undiagnosed

JAMA. 1980;243(14):1410. doi:10.1001/jama.1980.03300400008003

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An unexpectedly large number of elderly patients with chronic illnesses such as diabetes, rheumatoid arthritis, renal insufficiency, or malignant disease may also suffer from severe vertebral osteomyelitis and never know it, according to a report presented at the recent annual meeting of the American Academy of Orthopaedic Surgeons in Atlanta.

The report, made by Thomas N. Walinski, MD, associate clinical professor of orthopedics at the John A. Burns School of Medicine at the University of Hawaii, Honolulu, described the condition—vertebral osteomyelitis—as "the great masquerader." The classic symptoms—spinal pain, fever, chills, and general malaise—are often confused with chronic illnesses commonly found in the elderly, he said.

The orthopedist may be quick to associate the classic symptoms with the condition, but few such patients see an orthopod first, making early diagnosis much less likely.

In his study of patients with the disease, Walinski confirmed earlier findings that many cases of vertebral osteomyelitis