Osteomyelitis can be divided into “osteo” meaning bone and “myelitis” meaning inflammation of the fat tissues within the bone. Osteomyelitis results from bone or joint infection and can be both acute and chronic. It can occur at any age and can involve any bone. You can find more information below.

What is osteomyelitis (bone inflammation)?

Osteomyelitis is an infection in a bone. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Infections can also start in the bone itself if an injury exposes the bone to microbes. Smokers and people with chronic health conditions such as diabetes or kidney failure are at risk of developing osteomyelitis. People with diabetes may develop osteomyelitis in their feet if they have foot ulcers.

Although once considered incurable, osteomyelitis can now be successfully treated. Most people need surgery to remove areas of dead bone. Strong intravenous antibiotics are typically needed after surgery.

What causes osteomyelitis (bone inflammation)?

Most cases of osteoarthritis are caused by types of microbes known as staphylococcus bacteria, which are commonly found on the skin or even in the nose of healthy individuals.

Microbes can enter the bone in various ways, such as:

  • Bloodstream: Germs from other parts of your body – such as the lungs with pneumonia or the bladder due to a urinary tract infection – can travel from your bloodstream to a weakened spot in a bone.
  • Injuries: Severe puncture wounds can carry germs deep into your body. If such an injury becomes infected, germs can spread to a nearby bone. If a bone is severely broken, this is how germs can enter the body.
  • Surgery: Direct contamination with microbes can occur during surgeries to replace joints or repair fractures.

Who is at risk?

Your bones are normally resistant to infection, but this protection decreases as you age. Other factors that can make your bones more vulnerable to inflammation may include:

  • 1- Recent injury or orthopedic surgery
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A severe bone fracture or deep puncture wound gives bacteria a way into your bone or nearby tissue. A deep puncture wound, such as an animal bite or a nail piercing a shoe, can also provide a route for infection.

Surgery to repair broken bones or replace worn joints can also inadvertently open a way for microbes to enter the bone. Implanted orthopedic hardware is a risk factor for infection.

  • 2- Circulatory disorders

When blood vessels are damaged or blocked, your body has trouble distributing the infection-fighting cells needed to keep a minor infection from growing. What starts as a small cut can progress to a deep ulcer, which can expose deep tissue and bone to infection.

Diseases that impair blood circulation include poorly controlled diabetes, smoking-related peripheral artery disease, and sickle cell disease.

  • 3- Problems requiring intravenous line or catheter

There are a number of conditions that require the use of medical tubes to connect the outside world to your internal organs. However, this tube can also serve as a pathway for germs to enter your body, increasing your overall risk of infection, which can lead to osteomyelitis.

Examples of when such tubes can be used:

  • dialysis machine pipes
  • urinary catheters
  • Long-term intravenous tube, sometimes called central lines
  • 4- Conditions that impair the immune system

Your risk of osteomyelitis is higher if your immune system is affected by a medical condition or medication. Factors that can suppress your immune system include:

  • cancer treatment
  • poorly controlled diabetes
  • The need to take corticosteroids or medications called tumor necrosis factor inhibitors
  • 5- Illegal drugs

People who inject illicit drugs are more likely to develop osteomyelitis because they can use non-sterile needles and are less likely to sterilize their skin before injections.

What are the symptoms of osteomyelitis (bone inflammation)?

Symptoms of osteomyelitis (bone inflammation) include:

  • Fire
  • Swelling, warmth, and redness at the infection site
  • pain at the site of infection
  • Tiredness

Sometimes osteomyelitis causes no symptoms or it can be difficult to distinguish the symptoms from other problems. This can be especially true for infants, older adults, and people with compromised immune systems.

When should you see a doctor?

You should consult your doctor if you experience bone pain that worsens with fever. If you are at risk of infection due to a medical condition, recent surgery or injury, you should also consult your doctor immediately if you notice signs of infection.

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How is osteomyelitis (bone inflammation) diagnosed?

Your doctor may check the area around the affected bone for any tenderness, swelling, or warmth. If you have a foot ulcer, your doctor may use a probe to determine the proximity of the underlying bone.

Your doctor may order a combination of tests and procedures to diagnose osteomyelitis and determine which microbe is causing the infection. Tests may include:

blood tests

Blood tests can reveal high levels of white blood cells and other factors that indicate your body is fighting an infection. If osteomyelitis is caused by an infection in the blood, tests can reveal which microbes are to blame.

No blood test can tell your doctor if you have osteomyelitis. However, blood tests can give your doctor clues to help decide what additional tests and procedures may be needed.

Imaging tests

  • X-ray: Damage may not be visible on X- ray until osteomyelitis has been present for several weeks . More detailed imaging tests may be required if your osteomyelitis has developed more recently.
  • Magnetic resonance imaging: Using radio waves and a strong magnetic field, magnetic resonance imaging can produce extremely detailed images of bones and surrounding soft tissues.
  • Computed tomography: A computed tomography scan combines X-ray images taken from many different angles to create detailed cross-sectional views of a person’s internal structures.

Bone biopsy

A bone biopsy can reveal what kind of germ has infected your bone. Knowing the type of germ allows your doctor to choose an antibiotic that works particularly well for this type of infection.

An open biopsy requires anesthesia and surgery to access the bone. In some cases, the surgeon inserts a long needle into your skin and bone to perform a biopsy. This procedure requires local anesthetics to numb the area where the needle was inserted. X-ray or other imaging scans can be used for guidance.

How is osteomyelitis treated?

The most common treatments for osteomyelitis (bone inflammation) are surgery to remove sections of infected or dead bone, followed by intravenous antibiotics given in the hospital.

Surgical treatment

Depending on the severity of the infection, osteomyelitis surgery may include one or more of the following procedures:

  • Draining the infected area: Opening the area around your infected bone allows your surgeon to drain any pus or fluid that builds up in response to the infection.
  • Removing diseased bone and tissue: In a procedure called debridement, the surgeon removes as much of the diseased bone as possible and takes a small piece of healthy bone tissue to make sure all infected areas are removed. Surrounding tissue that shows signs of infection may also be removed.
  • Restoring blood flow to the bone: Your surgeon may fill in the empty spaces left by the debridement procedure with another tissue from another part of your body, such as a piece of bone, skin, or muscle.
  • Removing foreign bodies: In some cases, it may be necessary to remove foreign bodies, such as surgical plates or screws placed during a previous surgery.
  • Amputation of the limb: As a last resort, surgeons may amputate the affected limb to stop the infection from spreading further.
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Medication

A bone biopsy will reveal what type of germ is involved in your infection, so your doctor can choose an antibiotic that works well against such infections. Antibiotics are usually administered through a vein in your arm for about six weeks. An additional course of oral antibiotics may be required for more serious infections.

If you smoke, quitting smoking can speed recovery. If you have diabetes, it’s also important to take steps to manage your chronic conditions, such as keeping your blood sugar under control.

Can osteomyelitis (bone inflammation) be prevented?

If you’ve been told you have an increased risk of infection, you can talk to your doctor about ways to prevent infections from occurring. Reducing your risk of infection will also help your risk of developing osteomyelitis (bone inflammation).

In general, you can take precautions to avoid cuts, scrapes, and animal scratches or bites that allow germs to gain easy access to your body. If you or your child has a minor injury, it’s important to clean the area right away and apply a clean bandage. You should check the wounds frequently for signs of infection.

Frequently asked questions about osteomyelitis

Which doctor treats osteomyelitis?

If osteomyelitis is suspected, you should first see your family doctor. If your family doctor deems it necessary, he or she will refer you to an orthopedic specialist.

What happens if osteomyelitis is not treated?

If osteomyelitis is left untreated, the infection can become chronic and result in interruption of blood supply to the affected bone. When this occurs, it can lead to the eventual death of bone tissue.

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