Osteomyelitis

Osteomyelitis is an infection that negatively affects one or more bones. In most cases, the infection reaches the bone through the bloodstream or may form near the infected tissue. People may also experience osteomyelitis due to an injury that allows bacteria and other germs to reach the bone.

The risk of developing osteomyelitis increases significantly in people who smoke and have chronic health conditions (such as kidney failure, diabetes, and others). Osteomyelitis is also common in people with diabetes and foot ulcers.

The most common treatment for people with osteomyelitis is surgery to remove the affected bone. Moreover, almost everyone after surgery should get IV (intravenous) antibiotics.

Symptoms

Those who suffer from this infection usually experience the following symptoms. Examples include:

Swelling, tenderness, and warmth in the infected area
Pain
Tiredness
Fever

While some people with osteomyelitis do not experience symptoms, others may notice symptoms similar to other health conditions. It often occurs in infants, older adults, and people with weakened immune systems.

Immediately contact your healthcare professional if you experience bone pain and fever that does not improve within a few days. You should see a doctor if you experience infection symptoms after surgery or an injury.

Causes

In most cases, people develop osteomyelitis due to Staphylococcus bacteria that enter the bloodstream. However, bacteria and germs that can cause this condition live on the skin or nose of all people. Check below some ways how germs can enter a bone:

The bloodstream – The germs that enter the bloodstream can affect a weak spot on a bone. For example, certain germs can cause pneumonia in the lungs or urinary tract infections.
Injuries – When an injury becomes infected, the germs begin to spread into the nearby bones. They may also enter the body from a broken bone that sticks through the skin.
Surgery – Sometimes, germs enter the body during surgery done to treat other health problems.

Risk Factors

Generally, bones resist infections most of the time. The bones become more likely to become infected in older people. Check below some factors that elevate the risk of developing bone infections besides wounds and surgery:

Certain diseases that weaken the immune system – These include diabetes, HIV infection, and others.
Peripheral artery disease – A condition in which the arteries become narrowed and reduce blood flow to the legs or arms.
Sickle cell disease – This is a genetic disorder in which red blood cells reduce blood flow.
Dialysis or other medical procedures – This procedure involves specific tubes that help remove waste from the kidneys. These tubes can carry germs from outside the body into it.
Pressure injuries – These injuries often occur when a person stays in one position for long periods. Pressure injuries cause certain sores on the skin where the pressure occurs. Sometimes, a bone infection may occur under the sore.
Injectable illegal drugs – When the needle is not sterile or is used by multiple people, the risk of osteomyelitis significantly increases.

What Happens if Osteomyelitis is Left Untreated?

People with bone infections may also experience some complications, especially if they ignore the symptoms and do not get treatment. Check below some examples:

Osteonecrosis (also known as bone death) – When an infection reduces or blocks blood flow to the bone, it may lead to bone death. Usually, people with osteonecrosis need surgery to remove the affected bone and strong antibiotics to prevent the spread of the infection.
Septic arthritis – This complication occurs when the infection spreads to the nearby joint.
Impaired growth – If osteomyelitis occurs in a child, it may cause delayed bone growth. It frequently occurs if the infection affects soft areas (also called growth plates).
Chronic osteomyelitis (also called long-term osteomyelitis) – When you do not respond to treatments, you may develop the chronic form of the infection. It means that the infection cannot be cured.

How to Prevent Osteomyelitis?

People with an increased risk of bone infections should discuss it with their healthcare professionals about ways to prevent the infection.

In general, you should take care not to get scrapes, cuts, and animal scratches or bites. It helps prevent germs from entering the body. Sometimes, even a minor injury can allow the bacteria to enter the body and begin to multiply. Regularly check wounds for infection symptoms.

Diagnosis

Healthcare professionals usually begin osteomyelitis diagnosis with a physical examination to check for symptoms such as tenderness, swelling, or warmth of the area near the infected bone. For people who have a foot sore, doctors use a dull probe to determine how close the sore is to the bone.

However, healthcare professionals may perform additional tests to confirm the condition and exclude others that cause similar symptoms. For example:

Blood tests – Physicians usually perform these tests to check levels of white blood cells and other markers in the body that indicate the body fights against an infection. These tests may also show which germs have caused the infection. Unfortunately, there is no specific blood test that can confirm the disease.
Bone biopsy – This test is used to determine the exact type of germs that caused the bone infection. It helps make the best treatment plan for you. Sometimes, a bone biopsy is done during surgery.

Imaging Tests

Physicians often perform the following tests. For example:

X-rays – This imaging test helps determine damage to the bone. However, it can be used if you have osteomyelitis for at least 3 weeks.
MRI (magnetic resonance imaging) scan – This test uses a strong magnetic field and radio waves to make detailed pictures of bones and nearby soft tissues.
CT (computerized tomography) scan – It is often used to get cross-sectional images of different structures and organs of the body. A CT scan is often used when an MRI scan is not an option.
Bone scan – It is also called a nuclear imaging test that uses small amounts of radioactive material (also called radioactive tracers).

Treatment

The primary treatment for osteomyelitis is surgery to remove damaged or dead bone and strong antibiotics that prevent the spread of the infection. These antibiotics are often given to the patients intravenously (IV).

Surgery

According to the severity of the infection, surgery for osteomyelitis may involve multiple procedures. For example:

Drain the infected area to remove pus or fluid buildup caused by the infection
Remove damaged or diseased bone and tissue (this procedure is also known as debridement). During this procedure, surgeons may remove a small amount of healthy bone or tissue to make sure the infection is completely removed.
Restore blood flow – This procedure involves a bone graft or tissue graft that helps repair damaged blood vessels and make new ones.
Removal of foreign objects – These include surgical plates or screws often used in early stages of the surgery.

Medicines

Most people get strong intravenous antibiotics to prevent the spread of the infection. The treatment with these antibiotics may last up to 6 weeks.

Frequently Asked Questions

Can osteomyelitis be cured without surgery?

In some cases, this infection can be cured without surgery. Usually, when it is detected early and the infection is localized.

What is the life expectancy of someone with osteomyelitis?

Life expectancy differs among people. For instance, the prognosis is generally good if the infection is detected and treated in its early stages. However, people who develop the chronic form of the infection may experience life-threatening complications, which significantly reduce life expectancy.

Who usually gets osteomyelitis?

This condition is mostly diagnosed in children under 5 years old. Moreover, boys are more prone to develop this bone infection than girls. Ask your healthcare provider if you have additional questions.