Osteomyelitis

Overview

Definition

Osteomyelitis is an infection of the bone. It may be:

  • Acute—last a short time
  • Chronic—lasts a long time

Causes

Certain bacteria cause osteomyelitis. Bacteria can reach the bone through:

  • The bloodstream—blood can spread infection to other sites
  • A deep cut that exposes the bone to bacteria on the top of the skin
  • An infection in nearby tissue such as a skin ulcer

Risk Factors

Osteomyelitis is more common in adolescents and young adults. The risk of infection is also higher with 1 or more of the following:

  • Poor blood flow
  • Injured bones or skin
  • Recent joint surgery including fixing a broken bone
  • Soft tissue infection
  • Weakened immune system
  • IV drug use
  • Using a tube to drain urine or get medicine
  • Pressure injuries

SymptomsandDiagnosis

Symptoms

Osteomyelitis may cause:

  • Bone pain
  • Fever or chills
  • Soreness, warmth, swelling, or redness of the skin or joint
  • Drainage of pus
  • Nausea
  • Weight loss
  • Fatigue
  • Irritability
  • Problems moving a certain area
  • A sore over a bone that doesn't heal
Skin Infection Spreading to Bone
Bone Infection
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Diagnosis

The doctor will ask about symptoms and poor health. A physical exam will be done. Tests to look for signs or causes of infection may include:

  • Blood tests
  • Samples taken from infected area
  • Bone biopsy

Image tests may be done to see how much tissue is affected. Tests may include:

  • X-ray
  • MRI scan
  • CT scan
  • Bone scan
  • PET/CT scan

Treatments

Treatment

Antibiotics treat infections caused by bacteria. It may be given through an IV or through pills. It can take up to 6 weeks to treat acute osteomyelitis. Chronic osteomyelitis needs care for a longer period of time.

Surgery may be needed if medicine does not help or if the bone has hardware. Chronic osteomyelitis may also need surgery as part of treatment plan. The surgeon will remove dead or infected tissue and bone.

Prevention

Seek medical care for infections or injuries that may become infected. See your doctor for any sores that do not heal.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

National Institute of Arthritis and Musculoskeletal and Skin Diseases https://www.niams.nih.gov 

Ortho Info—American Academy of Orthopaedic Surgeons https://orthoinfo.org 

CANADIAN RESOURCES

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

When It Hurts to Move—Canadian Orthopaedic Foundation https://whenithurtstomove.org 

References

Calhoun JH, Manring MM. Adult osteomyelitis. Infect Dis Clin North Am. 2005 Dec;19(4):765.

Hatzenbuehler J, Pulling TJ. Diagnosis and management of osteomyelitis. Am Fam Physician. 2011 Nov 1;84(9):1027.

Hogan A, Heppert VG, Suda AJ. Osteomyelitis. Arch Orthop Trauma Surg. 2013 Sep;133(9):1183.

Osteomyelitis. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/osteomyelitis  . Accessed September 24, 2020.

Osteomyelitis. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/teens/osteomyelitis.html. Accessed September 24, 2020.