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A diagram showing three categories of osteomyelitis. (A and B) Primary hematogenous (blood borne) spread of bacteria mainly afflicts the vertebral bodies at all ages or the metaphysis of skeletally immature patients. (C and D) Contiguous bone infection is most commonly seen with direct contamination of bacteria in open fractures or joint replacement surgery with prosthetic implants. (E) Vascular or neurologic disease associated osteomyelitis most commonly affects the lower extremity.
