Consensus document for the diagnosis of peripheral bone infection in adults: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement)

Andor W.J.M. Glaudemans, Paul C. Jutte, Maria Adriana Cataldo, Victor Cassar-Pullicino, Olivier Gheysens, Olivier Borens, Andrej Trampuz, Klaus Wörtler, Nicola Petrosillo, Heinz Winkler, Alberto Signore, Luca Maria Sconfienza

Research output: Contribution to journalArticlepeer-review


Introduction: In adults with a suspicion of peripheral bone infection, evidence-based guidelines in choosing the most accurate diagnostic strategy are lacking. Aim and methods: To provide an evidence-based, multidisciplinary consensus document on the diagnostic management of adult patients with PBIs, we performed a systematic review of relevant infectious, microbiological, orthopedic, radiological, and nuclear medicine literature. Delegates from four European societies (European Bone and Joint Infection Society, European Society of Microbiology and Infectious Diseases, European Society or Radiology, and European Association of Nuclear Medicine) defined clinical questions to be addressed, thoroughly reviewed the literature pertinent to each of the questions, and thereby evaluated the diagnostic accuracy of each diagnostic technique. Inclusion of the papers per statement was based on a PICO (Population/problem – Intervention/indicator – Comparator – Outcome) question following the strategy reported by the Oxford Centre for Evidence-based Medicine. For each statement, the level of evidence was graded according to the 2011 review of the Oxford Centre for Evidence-based Medicine. All approved statements were addressed taking into consideration the available diagnostic procedures, patient acceptance, tolerability, complications, and costs in Europe. Finally, a commonly agreed-upon diagnostic flowchart was developed.

Original languageEnglish
Pages (from-to)957-970
Number of pages14
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Publication statusAccepted/In press - Jan 1 2019


  • Diagnosis of infection
  • Guideline
  • Imaging
  • Osteitis
  • Osteomyelitis
  • Peripheral bone infection

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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