• Osteomyelitis

    Definition

    Osteomyelitis is an infection of the bone. The infection may be:
    • Acute—for a short time
    • Chronic—lasting for a long time
    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.

    Causes

    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

    Risk Factors

    Osteomyelitis is more common in adolescents and young adults. Other factors that increase your chance of osteomyelitis include:
    • Poor circulation from disorders such as diabetes or peripheral vascular disease—slows 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

    Symptoms

    Symptoms include:
    • 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
    Skin Infection Spreading to Bone
    Bone Infection
    Copyright © Nucleus Medical Media, Inc.

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.
    Your bodily fluids, tissues, and bones may be tested to look for signs of infection. This can be done with:
    Images may be taken of the affected bone to look for abnormalities. This can be done with:

    Treatment

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

    Antibiotics

    The infection is treated with antibiotics. They are given by IV and sometimes by mouth. Acute osteomyelitis is generally treated for at least 4-6 weeks. Chronic osteomyelitis may require antibiotics for a longer period of time.

    Surgery

    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.

    Prevention

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

    RESOURCES

    National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov

    Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Foundation http://www.whenithurtstomove.org

    The Canadian Orthopaedic Association http://www.coa-aco.org

    References

    Carek PJ, Dickerson LM, Sack JL. Diagnosis and management of osteomyelitis. Am Fam Physician. 2001;63(12):2413-2420.

    Osteomyelitis. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-osteomyelitis. Updated September 3, 2014. Accessed January 19, 2017.

    Osteomyelitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116047/Osteomyelitis. Updated June 27, 2016. Accessed September 26, 2016.

    Osteomyelitis. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/infections-of-joints-and-bones/osteomyelitis. Updated October 2014. Accessed January 19, 2017.

    Osteomyelitis. Nemours Kids Health website. Available at: http://kidshealth.org/en/teens/osteomyelitis.html. Updated October 2013. Accessed January 19, 2017.

    Osteomyelitis. Patient UK website. Available at: http://patient.info/health/osteomyelitis-leaflet. Updated August 11, 2016. Accessed January 19, 2017.

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