What is Osteomyelitis?
Osteomyelitis is a term used to describe an infection that occurs inside a bone. The condition can manifest in any bone within your body.
Individuals of all ages can develop osteomyelitis. In adults, the bones of the feet, spine, and hips are most likely to be affected.
This type of infection can be acute (short-term) or chronic (long-term). Osteomyelitis is typically the result of a bacterial or fungal infection. (1)
Your bones are a type of living tissue. They are responsible for supporting the structure and mobility of your body, and store essential minerals.
Throughout your lifetime, your bones will go through a continuous process known as remodeling. Old bone tissue is removed and new bone tissue replaces it. (2)
Bones can be vulnerable to infections (osteomyelitis). Bacteria, fungi, or other types of germs can manifest in the affected bone.
These can spread to your bone from other areas of your body: for example, nearby muscles. Alternatively, infection can reach a bone through your bloodstream.
Occasionally, osteomyelitis can develop after a surgical procedure on the bone. This is more common when plates or prosthetics are involved.
Your health, lifestyle habits, and several other factors contribute to your chances of developing osteomyelitis.
Diabetics and individuals with a weak immune system are more at risk. The same is true of people with recent bone injuries or those who have just had bone surgery.
Kidney dialysis, poor blood circulation (e.g. due to diabetes), and injecting narcotics increases your likelihood of a bone infection. (3)
If you have already had osteomyelitis, you are more likely to develop it again. The symptoms of osteomyelitis can include the following: (4)
If you are experiencing pain in your bone, you may have osteomyelitis. The pain can be provoked by inflammation or infection of the bone.
Fever and Chills
A high fever accompanied by chills is a classic warning sign of infection. Seek medical
attention if your fever exceeds 100.4 degrees fahrenheit (38 degrees celsius). (5)
Swelling and Redness
Osteomyelitis can cause the area surrounding the bone to swell and turn red. It may also feel warm to the touch.
If you have an open wound accompanied by other symptoms, you may have
Osteomyelitis. This is particularly true of diabetics with recurrent foot ulcers. (6)
Osteomyelitis of the long bones (e.g. arms and legs) is usually staged according to the Cierny-Mader system.
This classification also accounts for the health of the patient, or host. Assessing the type of affected individual allows doctors to determine possible treatment options.
An “A” host is an individual of normal health. A “B” host has one or more health issues or compromising traits, such as extreme age or diabetes.
Finally, a “C” category host has grave health issues. If osteomyelitis is severe, treatment (e.g. surgery) can endanger the patient’s life.
The stages of long bone osteomyelitis itself can be described as follows: (7)
This stage is known as medullary osteomyelitis. The infection is confined to the medullary or marrow cavity.
This is the hollow area inside your bones where marrow is produced. It is located towards the middle of the long bones in your arms or legs. (8)
Osteomyelitis at stage two is classed as superficial. The infection has manifest in the outer layer of the bone, known as the cortical bone.
This type of osteomyelitis is usually caused by contagious focus. This refers to bacteria which have directly attacked the bone.
This can be caused by a contaminated prosthetic device. Bacteria can also enter the bone during a fracture. (9)
Localized osteomyelitis is an infection located in both the medullary and cortical bone. However, the bone is still stable.
By now, osteomyelitis is classed as diffuse, meaning it is affecting the entire bone. All layers (the bone’s diameter) are infected, and the bone is no longer stable.
If you present with the symptoms of osteomyelitis, your doctor will review your medical history.
This is to rule out other potential causes and assess known risk factors such as being diabetic, intravenous drug use, etc.
A physical examination will allow your doctor to check for external symptoms. For example, redness and swelling over the affected bone.
A series of tests will then be performed to identify what germs are provoking the infection. These include a complete blood count (CBC) and blood cultures.
Imaging tests such as an MRI, x-ray or CT scan of the affected bone may be taken to assess damage. A bone biopsy will also be taken to examine the tissue in a laboratory.
Treatments for osteomyelitis aim to eradicate the infection. Any damage to surrounding tissues and the bone itself will be addressed. (10)
Your doctor will recommend one or more of the following treatment options: (11)
Your doctor will prescribe antibiotics specific to the bacteria, germ or fungi causing your osteomyelitis. These drugs will kill off the offending culprits, stopping the infection.
You will likely be prescribed antibiotic tablets. Antibiotics for osteomyelitis are typically taken for four to six weeks, and in severe cases, up to 12 weeks.
If your infection is severe, you may be hospitalized for intravenous treatment. This means antibiotics will be administered to you directly through a vein.
Your doctor may recommend painkillers to help you to cope with the pain. These can range from over-the-counter to prescription-only medications, depending on your condition.
A splint is a type of device which immobilizes or supports an injured bone, allowing it to heal.
If you have osteomyelitis in a long bone, your doctor may splint the affected area to prevent movement.
Long bones include your legs and arms.
If you have severe osteomyelitis, you may require surgery. Your doctor may suggest surgery if you have an abscess within the infected bone.
An abscess is essentially a pocket filled with pus. Through surgical intervention, it can be drained of pus and removed.
Surgery may also be an option if the bone infection is threatening another structure of the body. For example, if the infection in your spinal vertebrae presses against the spinal cord.
Osteomyelitis can cause irreparable damage to the affected bone. In this case, your doctor will perform a ebridement.
Debridement is a procedure during which the damaged or dead part of the bone is removed.
Depending on the size of the removed bone segment, you may be left with an empty space in your bone. This space may be stuffed with dressing containing antibiotics.
You might require more than one of these surgeries to combat the infection. With repeated surgery, the skin and muscle near the affected bone can become damaged.
You might receive skin or muscle grafts taken from other areas of your body to repair this damage.
Diabetic individuals can develop a specific type of osteomyelitis. It is known as diabetic foot osteomyelitis (DFO).
Diabetes can result in poor blood circulation, which can then provoke foot ulcers. These ulcers can develop into osteomyelitis of the foot. (12)
If the bone is excessively damaged or cannot be salvaged, amputation may be required. The affected limb (e.g. foot or lower leg) will be surgically removed. (13)
What is osteomyelitis? Osteomyelitis is a medical term that refers to infection within a bone.
What are the signs of osteomyelitis? Signs of osteomyelitis can include bone pain, fever, chills, swelling and redness, and an open wound.
How do you develop osteomyelitis? Osteomyelitis develops when an infection occurs in your bone. The infection can develop in the bone directly, or spread to it from another part of your body.
How are you diagnosed for osteomyelitis? The condition can be diagnosed through blood tests, imaging tests, and a biopsy.
What is the best treatment for osteomyelitis? Treatment for osteomyelitis can include antibiotics, painkillers, splints, or surgery. In severe cases,amputation may be performed.
What are the long term complications of osteomyelitis? Chronic osteomyelitis can result in the formation of abscesses and may spread to surrounding bones. Bone death or deformation may occur if the condition goes untreated. (14, 15)
Is osteomyelitis considered a disability? If you have chronic osteomyelitis lasting for over a year with persistent, severe symptoms, you may be eligible for disability. Severe osteomyelitis in several bones can also qualify as a disability. (16)
Is there any cure for osteomyelitis? Acute osteomyelitis can be resolved with treatment. However, in some individuals osteomyelitis can recur and require long term management (e.g. antibiotics). (17)
The earlier osteomyelitis is diagnosed and treated, the better your prognosis will be. If you have symptoms of the condition, seek urgent medical attention. (20)
Assess your personal risk factors for osteomyelitis. Maintaining good hygiene and avoiding poor lifestyle habits (e.g. injecting drugs) can lower your risk.
If you are wounded, it is important to keep the area clean. Deep cuts or wounds which become contaminated can result in osteomyelitis. (21)