Action
Obtain laboratory studies: (Class I)
- CBC
- ESR
- CRP
- Blood cultures
Decision
Are ESR and CRP normal?
Yes
Consider other etiologies
No
- Order emergent or urgent MRI, depending on clinical suspicion
- Consider initiation of antibiotics before imaging is completed
- Most cases are caused by MSSA, though there have been increasing rates of MRSA, so IV vancomycin along with a broad-spectrum IV antibiotic such as ceftriaxone or meropenem should be started as empiric therapy until treatment can be guided by the culture results.
- Consider surgical consultation before imaging is completed
