Osteomyelitis – What is it, Symptoms and Treatments

Osteomyelitis – What it is, Symptoms and Treatments with surgery. In addition, Osteomyelitis is an infection in one or more bones , usually caused by a bacterial or fungal infection. Infections can reach a bone as they travel through the bloodstream or spread from nearby tissue. Infections can also start in the bone itself if an injury exposes the bone to germs. In children, osteomyelitis most commonly affects the long bones of the legs and upper arms. Adults are more likely to develop osteomyelitis in the bones that make up the spine (vertebra). People suffering from diabetes can develop Osteomyelitison your feet if you have foot ulcers.

Once considered an incurable condition, Osteomyelitis can be successfully treated today. Most people need surgery to remove parts of the bone that have died — followed by strong antibiotics, often given intravenously, typically for at least four to six weeks.

Causes of Osteomyelitis:  Most cases of Osteomyelitis are caused by staph bacteria, types of germs commonly found on the skin or in the nose of even healthy individuals. Germs can enter a bone in a number of ways, including:

• The Bloodstream: Germs in other parts of your body — for example, in the lungs from pneumonia or the bladder from a urinary tract infection — can travel through the bloodstream to a weakened spot in a bone . In children, osteomyelitis most often occurs in the softer areas, called growth plates, at either end of the long bones  of the arms and legs.
• Infected tissue or an infected prosthetic joint: Severe puncture wounds can carry germs deep inside your body. If that lesion becomes infected, the germs can spread to a nearby bone.
• Open Wounds: Germs can enter the body if you have broken a bone so severely that part of it is passing through your skin . Direct contamination can also occur during surgery to replace joints or repair fractures.

Osteomyelitis Symptoms:  Signs and symptoms of Osteomyelitis include:

• fever or chills
• Irritability or lethargy in young children
• Pain in the area of ​​infection
• Swelling, heat, and redness over the area of ​​infection

Sometimes osteomyelitis does not cause signs and symptoms or has signs and symptoms that are difficult to distinguish from other problems.

When to See a Doctor:  See your doctor if you have worsening bone pain along with fever. If you are at risk of infection because of a medical condition or recent surgery or injury, see your doctor right away if you notice signs and symptoms of an infection.

Complications of Osteomyelitis:  Complications of Osteomyelitis can include:

• Bone death (osteonecrosis): An infection in your bone can prevent blood flow within the bone, leading to bone death. Your bone may heal after surgery to remove small sections of dead bone. If a large part of your bone has died, however, you will need to have that limb surgically removed (amputated) to prevent the infection from spreading.
• Septic arthritis: In some cases, the infection in the bones can spread to a nearby joint.
• Impaired growth: In children, the most common location for osteomyelitis is in the softer areas, called growth plates, at either end of the long bones of the arms and legs. Normal growth can be stopped in infected bones.
• Skin cancer: If your osteomyelitis has resulted in an open sore that is draining pus, the surrounding skin is at a higher risk of developing squamous cell cancer.

Osteomyelitis Testing and Diagnosis:  Your doctor may feel the area around the affected bone for any tenderness, swelling, or heat. If you have a foot ulcer, your doctor may use a blunt probe to determine how close the underlying bone is. Your doctor may order a combination of tests and procedures to diagnose Osteomyelitis and determine which germ is causing the infection, such as:

Blood  Tests: Blood tests can reveal elevated levels of white blood cells and other factors that could indicate your body is fighting an infection. If your Osteomyelitis was caused by a blood infection, tests can reveal what the germs are responsible for. There is no blood test that will tell your doctor whether or not you have Osteomyelitis . However, blood tests provide clues that your doctor uses to decide what other tests and procedures you may need.

Image Tests:

• X-rays: X-rays can reveal damage to your bone . However, the damage may not be visible until Osteomyelitis has been present for several weeks. More detailed imaging tests may be needed if your osteomyelitis has developed more recently.
• Computed tomography (CT): A CT scan combines X-ray images from several different angles, creating detailed cross-sectional views of a person’s internal structures.
• Magnetic resonance imaging (MRI): Using radio waves and a strong magnetic field, MRI scans can produce exceptionally detailed images of bones and the soft tissues that surround them.

Bone Biopsy:  A bone biopsy is the gold standard for diagnosing Osteomyelitis as it can also reveal what particular type of germ has infected your bone . Knowing the type of germ allows your doctor to choose an antibiotic that works particularly well for this type of infection.

An open biopsy requires anesthesia and surgery to access the bone . In some situations, a surgeon inserts a long needle through your skin and into your bone to do a biopsy. This procedure requires local anesthesia to numb the area where the needle is inserted. X-ray scans or other images can be used for guidance.

Osteomyelitis  Treatments : The most common treatments for Osteomyelitis are surgery to remove infected or dead portions of bone , followed by antibiotics. Hospitalization is usually necessary.

Surgery:  Depending on the severity of the infection, osteomyelitis surgery may include one or more of the following:

• Drain the infected area: Opening the area around your infected bone allows your surgeon to drain any pus or fluid that has accumulated in response to the infection.
• Remove diseased bone and tissue: In a procedure called debridement, the surgeon removes as much diseased bone as possible and takes a small margin of healthy bone to ensure that all infected areas have been removed. Surrounding tissue that shows signs of infection can also be removed.
• Restore blood flow to the bone: Your surgeon may fill any empty space left by the debridement procedure with a piece of bone or other tissue, such as skin or muscle, from another part of your body.

Temporary fillers are sometimes placed in the pocket until you are healthy enough to undergo a bone graft or tissue graft. The graft helps the body repair damaged blood vessels and form new bone .

• Remove any foreign objects: In some cases, foreign objects such as surgical plates or screws placed during previous surgery may need to be removed.
• Ampute the limb: As a last resort, surgeons may amputate the affected limb to prevent the infection from spreading further.

Osteomyelitis Medications:  A bone biopsy will reveal what type of germ is causing your infection, so your doctor can choose an antibiotic that works particularly well for this type of infection. Antibiotics are usually given through a vein in the arm for at least four to six weeks. An additional course of oral antibiotics may be needed for more serious infections.

Preventing Osteomyelitis:  If you have been told that you are at an increased risk of infection, talk to your doctor about ways to prevent infections from occurring. Reducing your risk of infection will also reduce your risk of developing Osteomyelitis . In general, take precautions to avoid cuts and scrapes, which give germs easy access to your body. If you get cuts and scrapes, clean the area immediately and apply a clean bandage. Check wounds frequently for signs of infection.