Overview
Osteomyelitis is an infection in a bone, which can occur when germs travel through the bloodstream or spread from nearby tissue. It can also begin within the bone if an injury exposes the bone to germs. People who have diabetes, smoke, or have chronic health conditions are more at risk of developing osteomyelitis. Symptoms include fever, swelling, warmth, redness, and pain in the affected area, as well as fatigue. Treatment typically involves surgery to remove infected areas of the bone and strong intravenous antibiotics. Complications may include bone death, septic arthritis, and impaired growth in children. It is important to see a doctor if you experience worsening bone pain along with fever or if you are at risk of infection due to a medical condition or recent surgery or injury.
Understanding the disease
Symptoms
Symptoms of osteomyelitis may include fever, swelling, warmth, redness, pain, and fatigue in the affected area. Sometimes, there may be no visible symptoms, especially in infants, older adults, and individuals with compromised immune systems. If you experience worsening bone pain along with fever, it is recommended to consult a doctor. If you are at risk due to medical conditions, recent surgeries, or injuries, seek medical attention immediately if you notice signs of infection.
Risk Factors
Risk factors that can make your bones more vulnerable to osteomyelitis include:
- Recent injury or orthopedic surgery
- Surgery to repair broken bones or replace worn joints
- Circulation disorders, including poorly controlled diabetes, smoking, and certain diseases that impair blood circulation
- Illicit drug use, such as injecting nonsterile needles These factors can create an entry point for bacteria or reduce the body's ability to fight off infections, increasing the risk of osteomyelitis.
Development
Osteomyelitis can develop in a bone through several means:
- Traveling through the bloodstream: Infections can reach a bone by traveling through the bloodstream from another part of the body.
- Spreading from nearby tissue: Infections can spread from nearby tissue, such as skin, muscle, or soft tissue, to the bone.
- Direct injury exposure: An injury, such as a fracture or puncture wound, can expose the bone to germs, allowing infection to occur.
- Surgery-related complications: Surgical procedures, including orthopedic surgeries and procedures to repair broken bones or replace worn joints, can inadvertently create a pathway for germs to enter the bone. Implanted orthopedic hardware can also increase the risk of infection.
- Circulation disorders: Damage or blockage of blood vessels can impair the body's ability to distribute infection-fighting cells, increasing the risk of osteomyelitis. Poorly controlled diabetes, for example, can lead to circulation disorders that increase the risk of infection. In summary, osteomyelitis can develop through various means, including bloodstream infections, spread from nearby tissue, direct injury exposure, surgery-related complications, and circulation disorders.
Assessment and Diagnosis
Triage
You should see a doctor if you experience worsening bone pain along with fever, as these are common symptoms of osteomyelitis. Additionally, if you are at risk of infection due to medical conditions, recent surgery or injury, and notice signs and symptoms of an infection, consult your doctor immediately.
Diagnosis
To diagnose osteomyelitis, your doctor may perform a physical exam to check for tenderness, swelling, or warmth around the affected bone. They may also use imaging tests such as X-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scans to visualize the bone and detect any abnormalities or damage. Blood tests may be ordered to assess your body's response to infection and help determine the causative microorganism. In some cases, a bone biopsy may be necessary to identify the specific microorganism causing the infection.
Management and Treatment
Complications
Potential complications of osteomyelitis include bone death (osteonecrosis), septic arthritis, impaired growth, and skin cancer.
Prevention
Osteomyelitis is an infection in a bone that can be caused by bacteria or fungi entering the bone through the bloodstream or nearby tissue. While it was once considered incurable, it can now be successfully treated with surgery and antibiotics. People who are at a higher risk of developing osteomyelitis include smokers, those with chronic health conditions like diabetes, and those who have undergone recent injuries or surgeries. To prevent osteomyelitis, it is important to take precautions to avoid cuts, scrapes, and animal bites or scratches, and to clean and bandage any wounds immediately. Additionally, maintaining good blood circulation through proper diabetes management and regular exercise can help reduce the risk of developing osteomyelitis.
Treatment
Osteomyelitis can be successfully treated with a combination of surgery and antibiotics. Surgery is typically required to remove the infected bone tissue, which allows antibiotics to more effectively target the remaining infection. After surgery, strong intravenous antibiotics are usually prescribed to help eradicate the remaining bacteria. In some cases, oral antibiotics may be used for several months following surgery to ensure complete recovery. Additionally, addressing any underlying risk factors, such as diabetes or smoking, is crucial for preventing recurrence and promoting overall health.
Preparing for medical consultation
To prepare for an appointment for osteomyelitis, you should be aware of any pre-appointment restrictions and ask if there's anything you need to do in advance, such as restricting your diet or activities. It's also important to write down any symptoms you're experiencing, including those that may seem unrelated to the reason for the appointment. Prepare a list of your current medications, vitamins, or supplements, and bring your medical records and previous imaging or X-ray results to the appointment. Additionally, gather information about your recent medical history, any underlying conditions, and any recent travel or exposure to possible sources of infection. Consider bringing a family member or friend along to provide support and help remember important details discussed during the appointment.