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  • 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 vertebrae (bones of the back) are the most common sites. In children, the long bones are most likely to be affected. These are found in arms and legs.

    Causes

    This infection can occur as a result of an injury to the bone. It can also be caused by an infection in the body carried by the blood.

    Risk Factors

    Factors that increase your chance of osteomyelitis include:

    Symptoms

    Symptoms include:
    • Bone pain
    • Fever or chills
    • Tenderness, warmth, swelling, or redness of the skin or joint
    • Drainage of pus
    • Nausea
    • Fatigue or irritability
    • Restricted movement of the area
    • A sore over bone that does not heal
    Skin Infection Spreading to Bone
    Bone Infection
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    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
    • Blood tests—to check for signs of infection
    • Needle aspiration of a joint—use of a needle to remove a sample for testing and culture
    • Bone biopsy—removal of a sample of bone to test for abnormal cells
    • X-rays—bone and tissue changes on x-ray may indicate osteomyelitis
    • Bone scan—a series of pictures of bones taken after injection of a small amount of radioactive material that highlights the bones
    • CT or MRI—radiographic tests to evaluate any bone changes that may indicate osteomyelitis

    Treatment

    Your doctor may immobilize the affected area with a splint. He or she may also recommend avoiding any weight bearing on the area.

    Antibiotics

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

    Surgery

    For chronic infection, surgery may be required to:
    • Clean infected bone via scraping and irrigating the area
    • Remove any fragments of dead bone or tissue that may prolong the infection
    In severe cases, amputation may be necessary.

    Skin Graft

    In some situations, your doctor may recommend a skin graft. The skin in the affected area is replaced with healthy skin taken from another part of your body.
    If you are diagnosed with osteomyelitis, follow your doctor's instructions.
    If you are diagnosed with osteomyelitis, follow your doctor's instructions.

    Prevention

    To reduce your risk of getting osteomyelitis:
    • Seek immediate medical care for infections or injuries.
    • Keep diabetes under good control.
    • Do not use illegal drugs.
    • See your doctor for any sores that do not heal.
    • If you smoke, quit.

    RESOURCES

    American Academy of Orthopaedic Surgeons http://www.aaos.org

    US National Library of Medicine http://www.nlm.nih.gov

    CANADIAN RESOURCES

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

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

    References

    Bone and joint infections. Mayo Clinic Health Letter. February 26, 2001.

    Carek PJ, Dickerson LM, et al. Diagnosis and management of osteomyelitis. Am Fam Physician. 2001;63(12).

    Dambro MR. Griffith's 5-Minute Clinical Consult. Philadelphia, PA: Lippincott Williams & Wilkins; 2001.

    Osteomyelitis. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/osteomyelitis/DS00759. Updated June 2009. Accessed July 24, 2009.

    Revision Information

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