What is Osteomyelitis?
Osteomyelitis is an infection of a bone. Infections can come from the bloodstream or if germs are spread nearby. Infections can also start in the bone itself if an injury exposes it to germs.
Smokers and people with chronic health conditions are more likely to develop osteomyelitis. People with diabetes may develop osteomyelitis in their feet if they have foot ulcers.
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Medical terms
Osteomyelitis is a serious infection of the bone that can cause severe pain, joint damage, and even limb loss. The infection can be caused by bacteria, viruses, or fungi, and can occur after an injury or surgery. Treatment typically involves antibiotics and surgery.
Osteomyelitis is a bone infection that usually occurs as a result of bacteria entering the bone through an injury or surgery. The infection can also spread to the bone from an infection in another part of the body, such as the skin or bloodstream. Symptoms of osteomyelitis include pain, swelling, and redness at the site of the infection, as well as fever and chills. If left untreated, osteomyelitis can lead to serious complications, such as the spread of the infection to other parts of the body or damage to the bone.
Osteomyelitis is a serious condition that results from a bacterial infection in the bone. The infection can occur after an injury or surgery, or it can develop on its own. Osteomyelitis can be difficult to treat, and it can lead to serious complications, such as sepsis and death. Early diagnosis and treatment are essential to preventing these complications.
Symptoms Osteomyelitis
Signs and symptoms of osteomyelitis may include:
Fever
The area will be warm and red, indicating that the infection is spreading.
Pain in the area of the infection
Fatigue
If osteomyelitis (a type of infection in the bone) does not cause any signs or symptoms, it may be hard to tell that someone is infected. This may be especially true for infants, older adults, or people with weakened immune systems.
When to see a doctor
If you are experiencing worsening bone pain and fever, see your doctor. If you have any risk factors for infection, such as being a hospital patient or having recently had surgery or an injury, see your doctor right away to check for signs of an infection.
Causes Osteomyelitis
Osteomyelitis is most commonly caused by types of bacteria found on the skin or in the nose of healthy individuals.
Bones can be contaminated by germs in a variety of ways, including:
The bloodstream.Bacteria and viruses that are found in other parts of your body - for example, in the lungs from pneumonia or in the bladder from a urinary tract infection - can travel through your bloodstream and cause an infection at a weakened spot in a bone.
Injuries.If you are injured and develop a serious puncture wound, the germs inside your body can spread. Germs may also enter your body if a bone is broken so severely that part of it is protruding through the skin.
Surgery.Surgical procedures can become contaminated with germs.
Risk factors Osteomyelitis
Your bones are normally resistant to infection, but this protection decreases as you get older. Other factors that can increase your chances of developing osteomyelitis include:
Recent injury or orthopedic surgery
Bacteria can enter your bone if you have a severe fracture or if a deep wound is made. For example, an animal bite or a nail piercing through your shoe can also let bacteria in.
Injuries to bones or joints can also lead to germs entering the bone. This is especially a risk with surgeries to repair broken bones or replace worn joints, since implantable orthopedic hardware can increase the chances of infection.
Circulation disorders
If blood vessels are injured or blocked, the body's infectionfighting cells may not be able to reach the infection and it can become a large, dangerous ulcer.
Blocked blood vessels can lead to diseases, including:
Poorly controlled diabetes
Smoking is often a cause of peripheral artery disease.
Sickle cell disease
If you have a problem that requires an intravenous line or a catheter, that is a tube that goes down your throat and into your bladder, then you might need to go to the hospital.
Medical tubing can be used in a number of situations where it is necessary to connect the outside world to your internal organs. However, this tubing can also allow germs to enter your body, increasing your risk of an infection in general. This could lead to osteomyelitis.
This type of tubing might be used for a variety of purposes, including:
Dialysis machine tubing
Urinary catheters
Intravenous (IV) tubing can last for a long time.
Conditions that impair the immune system
If your immune system is weakened because of a medical condition or medication, you have a greater chance of developing osteomyelitis. Some factors that may suppress your immune system include:
Cancer treatment
Poorly controlled diabetes
Taking corticosteroids or drugs that block tumor necrosis factor can be necessary.
Illicit drugs
People who inject illegal drugs are more likely to develop osteomyelitis because they may not use sterile needles and are less likely to clean their skin before injections.
Complications Osteomyelitis
Complications of osteomyelitis may include:
Bone death (osteonecrosis).If you have an infection in your bone, this can impede the flow of blood within the bone and lead to bone death. If areas of bone die as a result, they need to be surgically removed for antibiotics to be effective.
Septic arthritis.Bones can become infected and spread the infection to nearby joints.
Impaired growth.If osteomyelitis occurs in the softer growth plates at either end of the long bones, normal bone growth in children may be affected.
Skin cancer.If your osteomyelitis has left an open sore that is draining pus, the surrounding skin is at a higher risk of developing squamous cell cancer.
Prevention Osteomyelitis
If you've been told that you have an increased risk of infection, talk to your doctor about ways to reduce your risk of getting infections. Reducing your risk of infection will also help your risk of developing osteomyelitis.
Protect yourself from cuts, scrapes, and bites by taking precautions such as washing the area immediately and applying a bandage. Be sure to check wounds frequently for signs of infection.
Diagnosis Osteomyelitis
Your doctor may feel the area around the affected bone to see if it is tender, swollen, or warm. If you have a foot ulcer, your doctor may use a dull probe to determine how close the underlying bone is.
Your doctor may order a variety of tests and procedures to diagnose osteomyelitis and to determine which germ is causing the infection. Tests may include: -A combination of tests to identify the cause of the infection -Procedures such as X-rays and blood tests
- Blood tests
If your white blood cells are elevated, this may indicate that you have an infection. If osteomyelitis is caused by an infection, the tests may reveal which germs are responsible.
A blood test cannot determine whether you have osteomyelitis, but it can provide clues to help your doctor make a determination about what additional tests and procedures may be necessary.
- Imaging tests
X-rays.X-rays can show damage to your bone. However, damage may not be visible until osteomyelitis - an infection of the bone - has been present for several weeks. If you have recently developed osteomyelitis, more-detailed imaging tests may be necessary.
Magnetic resonance imaging (MRI).MRI scans can produce detailed images of bones and the surrounding tissues with radio waves and a strong magnetic field.
Computerized tomography (CT).A CT scan combines X-ray images taken from many different angles, creating detailed cross-sectional views of a person's internal structures. CT scans are usually only done if someone cannot have an MRI.
- Bone biopsy
A bone biopsy can reveal the type of germ that has infected your bone. This information allows your doctor to prescribe an antibiotic that will work best against that type of infection.
A biopsy requires anesthesia and surgery to access the bone. Sometimes a surgeon inserts a long, thin needle through your skin and into your bone.This procedure numbs the area where the needle will be inserted with local anesthetics. X-ray or other imaging scans may be taken to determine the location of the biopsy. This is for guidance.
Treatment Osteomyelitis
Osteomyelitis is treated with surgery to remove infected or dead bone portions and antibiotics given in the hospital.
Surgery
If osteomyelitis is a severe infection, surgery may include one or more of the following procedures:
Drain the infected area.If you have an infection in your bone, your surgeon will be able to open up the area and drain any pus or fluid that has accumulated.
Remove diseased bone and tissue.The surgeon removes as much of the diseased bone as possible, taking a small margin of healthy bone to ensure that all infected areas have been removed. If surrounding tissue shows signs of infection, it may also be removed.
- Restore blood flow to the bone.After the debridement procedure, your surgeon may fill any empty space with bone or other tissue from another part of your body.Until you are healthy enough for a bone graft or tissue graft, a temporary filler will be placed in the pocket. This will help your body repair damaged blood vessels and create new bone.
Remove any foreign objects.Sometimes foreign objects such as medical plates or screws from a previous surgery have to be removed.
Amputate the limb.If the infection has spread to a limb, surgeons may have to amputate it to stop the infection from spreading.
Medications
A bone biopsy will show what kind of germ is causing your infection, so your doctor can choose an antibiotic that will work well against that type of infection. The antibiotics are usually given intravenously (through a vein in your arm) for about six weeks. Oral antibiotics may be prescribed as a follow-up if the initial course of antibiotics did not work. This antibiotic is only necessary for more serious infections.
If you want to quit smoking, it can help speed healing. Additionally, you'll need to take steps to manage any chronic conditions you may have - such as keeping your blood sugar under control if you have diabetes.
- Healthy foods for the musculoskeletal system
- Rehabilitation program and health tips for the musculoskeletal system
Preparing for your appointment
If you have signs or symptoms that suggest a possible infection, you might be referred to a doctor who is knowledgeable about infectious diseases or to an orthopedic surgeon.
Here are some things to know before your appointment and what to expect from your doctor.
What you can do
Please be aware of any restrictions that may apply before your appointment.When you make the appointment, be sure to ask if there is anything you need to do in advance, such as limiting your diet.
When you experience symptoms, write them down.Make sure to bring any relevant materials, including any that may seem unrelated to the reason for which you scheduled the appointment.
Make a list of all medications,The vitamins and supplements you're taking.
Write down questions to ask your doctor.
When you have osteomyelitis, some basic questions to ask your doctor include:
What are the most likely causes of my symptoms?
What should I do to prepare for the tests? Do these tests require any special preparations?
What treatments are available and which would you recommend?
Will surgery be necessary?
What are the possible side effects of treatment?
How long will it take for my symptoms to improve?
I have other health conditions. How can I best manage my conditions together?
Can I substitute a different medicine for the one you're prescribing?
Can I take any brochures or printed material home with me? What websites do you recommend visiting?
What to expect from your doctor
Your doctor may ask you a number of questions, such as:
When did you start feeling sick?
Do you have a fever or chills?
What are the symptoms you're experiencing?
Are you injured right now?
Have you had surgery recently?
What does it mean when you say someone has surgery?
Can you have diabetes? Do you have any ulcers on your feet?
General summary
Osteomyelitis is a bone infection that has a range of possible causes. The condition usually develops when bacteria or fungi enter the bone, often through a wound or break in the skin. The bacteria or fungi multiply and begin to destroy the bone tissue. Osteomyelitis can also develop when an infection in another area of the body, such as the bloodstream, spreads through the body and reaches the bone.
Osteomyelitis is an infection of the bone. It’s caused by bacteria, fungi, or other germs. These germs enter the bone through a break in the skin, a surgical wound, or a joint replacement. Osteomyelitis can happen at any age, but it’s most common in children and older adults.