Do you routinely recommend treatment for patients with chronic osteomyelitis of long bones based on radiographic findings alone in the absence of superficial infection or recommend bone biopsy to evaluate for therapy?

Do you routinely recommend treatment for patients with chronic osteomyelitis of long bones based on radiographic findings alone in the absence of superficial infection or recommend bone biopsy to evaluate for therapy?

• I would offer treatment if the patient has never been treated previously
• I would obtain bone cultures and biopsy to determine if there is truly osteomyelitis and then offer culture-directed antibiotics
• I would not offer treatment for chronic osteomyelitis in the absence of overlying soft tissue infection
• Other