What is the earliest bony change of osteomyelitis on X-rays?: (A) Loss of soft tissue planes, (B) Periosteal reaction, (C) Sequestrum formation, (D) Lytic defects
Answer is B. Pyogenic osteomyelitis on X-ray in 24-48 hours will show loss of soft tissue planes (earliest change on X-ray). Day 7 to 10-solid periosteal reaction (earliest bony change on X-ray).