Osteomyelitis is a condition where the bone is infected by micro-organisms. About 2 out of every 10,000 people are affected by this bone infection. Osteomyelitis is a rare but serious condition. It can be acute or if left untreated, the infection can become severe and become a chronic condition causing loss of blood supply to the affected bone. The infection spreads to the bone through the tissues or travels through the bloodstream.
What Causes Osteomyelitis?
- Osteomyelitis can be caused by a variety of micro-organisms, the most common bacteria being Staphylococcus aureus.
- Open wounds to the bone, such as a fracture with the bone end exposed through the skin.
- In case of minor trauma, a blood clot can form around the bone and then a secondary infection may follow.
- Bacteria present in the bloodstream termed as bacteremia gets deposited in a focal area of the bone. The bacteria deposited area in the bone then grows, resulting in the destruction of the bone. However, new bone is formed around this area.
- Infections of the soft tissues or open wounds can spread to the bones, resulting in a direct infection of the bone.
Types of Osteomyelitis:
Acute Osteomyelitis
Also called Haematogeous osteomyelitis, it is caused by an open fracture or bone operation. This is the most common osteomyelitis and is often seen in children.
Secondary Osteomyelitis
This condition arises from a wound infection in open fractures or after operations on the bone. The incidence of these cases is on the rise because of an increase in operative intervention in the treatment of fractures. This condition can be prevented by adequate initial treatment of open fractures and adherence to sterile operating conditions for routine orthopaedic operations.
Chronic Osteomyelitis
Although the incidence of chronic osteomyelitis is on the decline in developed countries, it continues to be an important problem in developing countries. Infections such as tuberculosis or fungal infections can also cause chronic osteomyelitis.
Symptoms
Signs and symptoms of osteomyelitis include:
- Fever
- Redness, swelling, and warmth over the infected area
- Pain in the area of infection
- Fatigue
- Nausea, from being ill with an infection.
- General sense of discomfort, uneasiness, or ill health.
- Pus (yellow thick fluid) draining through the skin.
- Having difficulty moving joints in the affected area
- An inability to bear weight or walk
- Development of new limp
- A stiff back (with vertebral involvement)
How is osteomyelitis diagnosed?
To identify osteomyelitis, a thorough history and physical exam are done to indicate signs of osteomyelitis. Additional tests generally include blood tests that look at white blood cells as well as markers for inflammation that are usually elevated during an infection. To determine if there are organisms in the blood that are causing the infection, a blood culture can also be performed.
To examine the affected area, X-rays are taken. In the early stages of infection, x-ray results may be normal. Bone pain or inflammation can be evaluated using magnetic resonance imaging (MRI) or bone scans. To diagnose later stages of osteomyelitis Computed tomography (CT) scans are helpful.
Finally, bone aspirations or biopsies may aid in the diagnosis and determination of the most suitable treatment for osteomyelitis. These procedures are performed under general anesthesia in the operating room.
Treatment for Osteomyelitis
- In order to determine the appropriate treatment for osteomyelitis, your doctor will look at the following:
- Age, health status, and medical history
- Severeness of the condition
- How you respond to specific medications, procedures, and therapies
Osteomyelitis treatment aims to cure the infection and minimize potential long-term complications. Treatment may include:
- Medications: Antibiotics are administered intravenously (IV), which can be done in the hospital or as an outpatient procedure. A course of intravenous or oral antibiotics for osteomyelitis may last for several weeks. It is important for the patient to continue to take antibiotics for as long as recommended by the doctor, even after symptoms of the infection have resolved.
- Monitoring of successive X-rays and blood tests
- Pain management
- Complete bed rest (or limiting movement in the affected area)
- Surgery. It may be necessary to perform surgery to drain infected fluids or remove damaged tissue and bone.
Prevention
If you have been facing symptoms of osteomyelitis or likely suffering from risk of infection, consult a doctor immediately and get to know the ways of prevent infections from occurring. Your risk of developing osteomyelitis will also be reduced if you reduce your infection risk.
One should take precautions to avoid cuts, scrapes, and animal bites and scratches, as these injuries allow germs easy access to your body. A minor injury should be cleaned and bandaged immediately if it occurs to both adults and children. Always check wounds often for signs of infection and regularly dress them as and when required.
