Atrium Health Navicent Musculoskeletal Care Orthopedic Trauma

Osteomyelitis

The definition of osteomyelitis is an infection of the bone. The treatment and outcome of having such an infection varies depending on the timing and severity. If left untreated, the infection could move through an individual's bloodstream, or to the surrounding tissue that is nearby. Once in the bloodstream, the infection can spread and become life-threatening. If the infection spreads to the surrounding tissue, such as one's leg, an untreated infection can result in the need to an amputation.

What are the Symptoms of Osteomyelitis?

Symptoms of osteomyelitis include pain in the area where the infection has occurred and a draining wound. A person might also suffer from irritability or lethargy; yet, this is more common with young children. There could also be redness as well as warmth in the area of the body where the infection is located. There are also situations where osteomyelitis can be present with no symptoms or signs.

Who is at Risk?

It has been estimated that 1 out of every 5,000 people will experience osteomyelitis at some point in their life. At risk patients for osteomyelitis are the same as mentioned above for orthopedic infections. In particular, any reason a patient has a weakened immune system would make them more susceptible. For example, a patient with HIV or AIDS, diabetics, intravenous drug users, alcoholics, smokers, as well as people who have a long history of steroid use. Additionally, prior surgeries, such as for knee and hip replacements or any type of bone surgeries, increases the risk of developing osteomyelitis.

How is Osteomyelitis Diagnosed?

The process involved with making a proper diagnosis of osteomyelitis can be complicated. It involves analyzing a combination of clinical tests. This could include such indirect laboratory markers as a white blood cell count, erythrocyte sedimentation rate, or C-reactive protein. The initial steps used for diagnosis are obtaining a thorough history & physical exam, and X-rays. An MRI may be needed to assess further the extent of the infection. This will show any soft tissue and bone marrow involvement and any type of cortical destruction that is present. Performing a bone biopsy may be necessary to obtain culture material for determining the specific pathogens present in the bone. This is a more reliable method than a simple needle puncture or surface swab.

Treatment of Osteomyelitis

The goals of treatment are infection eradication, prevention of recurrence, and preservation of function. The treatment used depends on the severity of the infection. In some cases, it can be treated with antibiotics alone. Antibiotics are administered through either orally or intravenously. Antibiotic treatments can last several weeks depending on the level of bacteria and how the patient is responding. The use of antibiotics will be guided by the infectious disease physician. In other situations, surgery is required as well. The purpose of surgery is to remove any infected tissue or bone. This step treats the active infection and attempts to prevent recurrence and/or spread to other parts of the body. In some situations, amputation is the only alternative. When osteomyelitis is diagnosed early and properly treated, the outlook for recovery can be very good.

Osteomyelitis Prevention

The most effective way to prevent an infection of the bone like osteomyelitis is to treat any type of skin or wound infections properly. A minor skin wound needs to be carefully cleaned and covered with a sterile bandage. Any sign of infection should be cause for concern. This includes swelling, pain, discharge, redness and more. Any deep wound or bone injury needs immediate medical attention.