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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Osteomyelitis

What is it?

Osteomyelitis is infection of the bone. The infection can originate in another part of the body (in the throat or skin, for example) and spread to the bones via the bloodstream, or it can develop after a bone fracture has broken the skin, infecting the bone directly. It may also spread from an adjacent area of infection, or settle in an area with inadequate circulation. The infected bone becomes inflamed, resulting in severe bone pain, fever, and the formation of pus. Single episodes of the disorder, known as acute osteomyelitis, are most common in the arm and leg bones of rapidly growing children. Chronic osteomyelitis, a rare and stubborn form of the condition, causes persistent bone pain for years. This form of the disease may also lead to complications, including skin abscess, bone deformity, cessation of bone growth in children, and amyloidosis (the deposition of a waxy substance into tissues and vital organs). Chronic osteomyelitis is more prevalent among adults and most often affects the vertebrae or pelvis.With prompt attention, acute osteomyelitis can usually be treated successfully with antibiotics. Chronic osteomyelitis, however, is more difficult to treat and frequently requires surgery to remove the affected bone.

What Causes It?

  • Acute osteomyelitis occurs when infectious organisms— usually bacteria—invade bone tissue. (Rarely, a fungal infection is the cause.) A bone is more susceptible to infection after a blunt physical trauma or fracture.
  • Possible causes of chronic osteomyelitis include an acute case that is ignored or fails to respond to treatment; a compound bone fracture; and tuberculosis that spreads to the bone from elsewhere in the body.

Prevention

  • Get prompt and thorough medical treatment for any bacterial infection before it can spread to the bones or other organs.

Diagnosis

  • Patient history and physical examination are needed.
  • Blood cultures may identify the organism responsible for infection.
  • Bone scans can be used for early detection of osteomyelitis.
  • Bone x-rays may also detect osteomyelitis, but usually only two to three weeks after infection.
  • Biopsy (a small sample of tissue or pus removed for microscopic examination) can be taken to identify the infectious organism if blood cultures fail.

How to Treat It

  • Acute osteomyelitis can usually be cured with an extended course of antibiotics, given orally or intravenously over a period of weeks or months.
  • Bed rest and immobilization of the affected area may be advised.
  • If antibiotics fail to cure the infection, surgery to drain pus and remove infected or dead tissue may be warranted.
  • The only effective treatment for chronic osteomyelitis is surgical removal of the affected bone tissue and any foreign bodies such as prosthetic devices. Bone grafting may be necessary in such cases.

When to Call a Doctor

  • If you experience the symptoms of osteomyelitis, see your doctor.
  • If you develop any sign of complication during treatment for osteomyelitis (including formation of or increased drainage from an abscess, fever, unbearable pain), see a doctor immediately.
  • If you previously had osteomyelitis and experience any of the symptoms of recurrence, see a doctor as soon as possible.