OSTEOMYELITIS

 Basic information

description

Osteomyelitis is an infection of the bone. It can involve any bone in the body. In a child, it usually affects the femur (upper leg bone), tibia (lower leg bone), or the humerus or radius (bones in the arm). In an adult, it usually affects the pelvis or spine. It occurs in both sexes and all ages (often children and elderly).

FREQUENT SIGNS & SYMPTOMS

• High fever.
• Pain, swelling, redness, warmth, and tenderness in the area over the infected bone, especially when moving a nearby joint. Nearby joints, such as the knee, may also be red, warm, and swollen.
• May have limited use or not be able to use an infected extremity (arm or leg).
• Child may guard or protect area from being touched.
• General ill feeling.
• Excessive sweating, chills, back pain (sometimes).

causes

Bacterial infection (e.g., Staphylococcus aureus) is the most common cause. Other infections are more rare. Bones can be infected by: bacteria in the bloodstream from infection in another body part; bacteria in soft body tissue located next to the bone; and bacteria that directly infects the bone.

risk increases with

• Recent injury or surgery (especially orthopedic).
• Diabetes, sickle cell anemia, or chronic joint disease.
• Infection that occurs in another part of the body.
• People on dialysis (hemodialysis).
• Weak immune system due to illness or drugs.
• Intravenous (IV) drug abuse.

PREVENTIVE MEASURES

Obtain prompt medical treatment of any bacterial infection to prevent its spread to bone or other body parts.

expected outcomes

Outcome will depend on severity of infection, effectiveness of drug treatment, results of surgical procedures, and the health of patient. With early diagnosis and treatment, most patients recover with no complications.

possible complications

• Chronic osteomyelitis. It may last for months or years and be difficult to treat. It can cause periodic bone pain, tenderness, and abscess (area of pus) that may drain through the skin. Treatment may require more surgery and drugs for an extended period of time.
• Reduced function of the affected limb and joint.
• Bone fractures.
• Serious blood infection (sepsis).
• Recurrence of the infection.
• Rarely, treatment is unsuccessful and surgery may be done to fuse the joint or amputate the limb.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam of the affected area. Medical tests include blood studies and cultures to identify the bacteria. Samples of pus, joint fluid, and infected bone may be removed and used for tests to confirm the diagnosis. Imaging studies such as x-rays, bone scan, CT, or MRI may be done.
• Treatment usually involves hospital care, drug therapy, rest, and other supportive measures.
• The affected bone and joint may be immobilized (not allowed to move). Bracing may be used for the spine.
• Surgery may be done to drain an abscess, remove dead bone tissue or infected bone, and to stabilize the spine. Bone or skin grafts may be required.
• An artificial joint that is infected may need to be removed and replaced.

medications

• Antibiotics will be prescribed to treat the infection. They are sometimes given through a vein (IV) while in the hospital. The drugs usually need to be continued at home after the hospital stay. This may be done by continuing the IV drugs or with drugs that are taken by mouth.
• Pain relievers may be prescribed.

activity

• Rest in bed until symptoms get better. Resume your normal activities gradually.
• Physical therapy may be recommended to help affected limbs and joints regain function and flexibility.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of osteomyelitis.
• Symptoms persist or recur despite treatment.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Special Notes: