Osteomyelitis is traditionally subdivided into three categories based on etiology. The first type is hematogenous osteomyelitis. This form is commonly monomicrobial, with staphylococcal organisms isolated most frequently. 7 The second type is direct extension osteomyelitis. It is usually polymicrobial in origin and seen more frequently in the general population. 6 Sources of direct extension osteomyelitis include puncture wounds, surgery, implants, contiguous ulcerations, and septic arthritis.