Diabetic-foot bone infection is difficult to diagnose, and machine learning may help clinicians use clinical information and medical images. We reviewed studies that developed or evaluated these models for diabetic-foot osteomyelitis. Most focused on diagnosis using either clinical and laboratory information or imaging. No study combined these sources, and testing in new groups was uncommon. Future research should combine clinical information with imaging and test models in other groups.

Culture-negative periprosthetic joint infection (CN-PJI) remains a diagnostic and therapeutic challenge. In this systematic review and meta-analysis of 27 studies (1399 patients), pooled success was 83.6 %, failure was 17.2 %, and mortality was 2.4 %. Outcomes were better with exchange arthroplasty than debridement, antimicrobials, and implant retention (DAIR). Antibiotic regimens were heterogeneous. Overall, CN-PJI may have favorable outcomes, but standardized prospective studies are needed.

Native vertebral osteomyelitis, a spinal bone infection, is difficult to diagnose, and delays can worsen outcomes. This review examines how traditional laboratory tests and newer genetic techniques can be integrated to improve identification of the responsible microorganism. We show that combining these approaches within the diagnostic pathway may increase accuracy and support earlier diagnosis, enabling more timely and informed treatment decisions.

In Lyme-endemic regions, Lyme disease should be considered in culture-negative periprosthetic joint infection (PJI). Diagnosis relies on microbial DNA detection, particularly Borrelia-targeted polymerase chain reaction (PCR) on synovial fluid or tissue. We present 10 cases highlighting the value of PCR for early recognition of this pathogen, which is not detectable by conventional culture media. Surgical debridement remains the standard of care, though several cases were successfully treated medically, an observation that merits further investigation.

The rising rate of spinal surgeries has led to more postoperative infections, yet no standardized diagnostic criteria exist. We analyzed over 100 studies and found considerable variation in definitions. Our findings underscore the need for a unified diagnostic framework that integrates clinical signs, laboratory data, and imaging to enhance diagnostic accuracy, support clinical decision-making, and improve consistency in future research.