Osteomyelitis

Osteomyelitis is an infection in the bone that causes inflammation of bone tissue, resulting in bone pain and a variety of other symptoms. It can occur for several reasons, and affects about two in 10,000 people, both children and adults.

Until recently, osteomyelitis was considered incurable. Now we have several successful treatment options for both acute osteomyelitis and chronic osteomyelitis, including surgery.

Grandfather and child smiling at park

Causes and common symptoms

Who gets osteomyelitis

Osteomyelitis is more common in babies, children and older adults, but it can affect anyone.

In children, it typically affects the long bones of the arms or legs. In adults, it often affects the spine. The most common cause is bacterial infection in the blood, usually staphylococcus aureus, but there are other causes of osteomyelitis, including:

  • Diabetes, especially from a foot ulcer or other chronic soft tissue infection.
  • Frequent medicine injections.
  • Injury or surgery, especially from open wounds.
  • Prosthetic devices.
  • Weakened immune system, from HIV or from getting cancer treatment.

Symptoms can vary

Symptoms of osteomyelitis vary, depending on the cause and whether it starts quickly or slowly, and many present as signs of infection. The most common include:

  • A new limp.
  • A stiff back if the spine is affected.
  • Feeling ill.
  • Fever, which may become high.
  • Irritability.
  • Lethargy or fatigue.
  • Pain, redness, swelling and/or warmth in the infected area.
  • Trouble bearing weight or walking, and moving joints near the infected area.
  • Weight loss.

The symptoms of osteomyelitis may look like other medical conditions like an infectious disease or septic arthritis – which is an orthopedic emergency – so you should meet with a UCHealth provider right away for a proper diagnosis.

Treatment options

To successfully treat osteomyelitis, your UCHealth specialist typically performs surgery to remove the infected and dead bone, followed by a course of intravenous antibiotics to kill the underlying bacteria and infection.

But first, you might be directed to begin a six-week course of intravenous (and possibly oral) antibiotics. If it turns out that surgery is necessary, your orthopedic surgeon will recommend the right procedure for your case:

  • Debridement. Your surgeon removes all diseased bone and tissue plus a small margin of healthy bone and tissue to ensure that all the infected areas are gone.
  • Drain the infected area. Your surgeon opens up the area around your infected bone and drains any pus or fluid that has accumulated.
  • Graft. Your surgeon restores blood flow to the bone after debridement by grafting a piece of bone or other tissue, such as skin or muscle, from another part of your body. Sometimes temporary fillers are placed in the pocket until a graft is possible.
  • Removal of foreign objects. Surgical plates or screws placed during a previous surgery may have to be removed.

As a last resort, your surgeon may amputate the affected limb to stop the infection from spreading further.

Life after osteomyelitis

With a treatment plan we personalize for you, your prognosis is very good.

If you smoke, quit – your recovery will happen faster. You’ll need to manage any chronic conditions you have, especially diabetes.

You can overcome osteomyelitis and enjoy the quality of life you want once again.

References

National Library of Medicine. Osteomyelitis (https://www.ncbi.nlm.nih.gov/books/NBK532250/)

MedlinePlus: National Library of Medicine. Osteomyelitis (https://medlineplus.gov/ency/article/000437.htm)