Osteomyelitis

What is osteomyelitis?

Osteomyelitis is an infection of the bone. Osteomyelitis is more common in adolescents and young adults. In adults, the pelvis and the bones of the back are the most common sites. In children, the long bones are most likely to be affected. These are found in the arms and legs.

Osteomyelitis is caused by bacteria that comes in contact with bone tissue and begin to grow. The bacteria may reach the bone through:

• Bloodstream—blood can carry bacteria from an infection in another part of the body.
• Deep cut that exposes the bone to bacteria on the surface of the skin or environment.
• An infection in a nearby tissue, such as a skin ulcer.

What are the risk factors for osteomyelitis?

Factors that increase your chance of osteomyelitis include:

• Poor circulation from disorders such as diabetes or peripheral vascular disease because these disorders slow healing and increase risk of infection.
• Trauma or injury to the bone and skin.
• Recent surgery on a joint or bone, such as a hip replacement or internal fixation of a fracture.
• Soft tissue infection.
• Weakened immune system.
• IV drug use.
• Catheter use.
• Pressure ulcers.

To reduce your risk of osteomyelitis:

• Seek immediate medical care for infections or injuries.
• Keep diabetes under control.
• Do not use illegal drugs.
• See your healthcare provider for any sores that do not heal.
• If you smoke, talk to your healthcare provider about how you can successfully quit.

What are the symptoms of osteomyelitis?

How is osteomyelitis diagnosed?

To diagnose osteomyelitis, your doctor may test your bodily fluids, tissues, and bones to look for signs of infection. This can be done with:

• Blood tests.
• Skin wound cultures.
• Bone biopsy.

Images may be taken of the affected bone to look for abnormalities. This can be done with:

• X-ray.
• MRI scan.
• CT scan.
• Bone scan.
• PET/CT scan.

How is osteomyelitis treated?

The affected area may be treated with a splint to prevent it from moving. Avoiding weight bearing activities may also be advised.

The infection is treated with antibiotics. They are given by IV and sometimes by mouth. Acute osteomyelitis is generally treated for at least four to six weeks. Chronic osteomyelitis may require antibiotics for a longer period of time.

Surgery may be needed to remove dead tissue and bone. In some situations, a skin graft may be needed to replaced removed tissue and close the wound. The skin in the affected area is replaced with healthy skin taken from another part of the body.

In severe cases, amputation may be necessary.

When should I contact my healthcare provider?

Make an appointment with your healthcare provider if you have any of the following symptoms related to osteomyelitis:

• Bone pain.
• Fever or chills.
• Tenderness, warmth, swelling, or redness of the skin or joint.
• Drainage of pus.
• Nausea.
• Weight loss.
• Fatigue or irritability.
• Restricted movement of the area.
• A sore over a bone that does not heal.