Osteomyelitis

Bone infections, called osteomyelitis, happen when germs invade a bone. This infection can affect a single part of the bone or multiple parts. Germs can reach the bone through the bloodstream, or they might spread from a nearby infection. Sometimes, an injury that breaks the skin and exposes the bone can allow germs to enter and cause the infection.

Certain groups of people are more likely to develop osteomyelitis. These include smokers and people with long-term health problems like diabetes or kidney disease. For example, people with diabetes who have sores on their feet are especially at risk of getting osteomyelitis in their foot bones.

Treating osteomyelitis often requires surgery to remove the infected bone tissue. This is typically followed by a course of powerful antibiotics delivered directly into the bloodstream through a vein (an intravenous injection).

Osteomyelitis is a bone infection. It can cause a range of symptoms, but sometimes there are no noticeable signs. Key symptoms often include:

• Local signs: Swelling, warmth, and tenderness in the area where the infection is located. You'll likely feel pain near the infected spot.
• General symptoms: Feeling tired, and having a fever are also possible signs.

Important Note: The symptoms of osteomyelitis can be similar to other illnesses, especially in babies, older adults, and people with weakened immune systems. This can make diagnosis tricky.

If you have a fever and bone pain that's getting worse, it's important to see a doctor. If you have a medical condition that puts you at higher risk for infections, like after surgery or an injury, see a doctor right away if you suspect any signs of infection, even if the symptoms are mild. Early diagnosis and treatment are crucial for preventing complications.

If you have a fever and your bone pain is getting worse, see a doctor. It's important to get medical attention quickly if you have symptoms of infection, especially if you have a medical condition that makes you more likely to get sick, or if you've recently had surgery or an injury. See a doctor right away if you think you might have an infection.

Staph bacteria are a common cause of osteomyelitis. These bacteria are tiny organisms that live on the skin or inside the noses of most people. They're usually harmless, but they can cause problems if they get into a bone.

Staph bacteria can enter a bone in a few ways:

• Through the bloodstream: Sometimes, bacteria from other parts of the body, like a lung infection (pneumonia) or a bladder infection (urinary tract infection), can travel through the bloodstream. If the bacteria reach a weakened or damaged area of a bone, they can set up an infection there.

• Through injuries: Deep cuts, especially puncture wounds, can let bacteria enter the body. If an injury gets infected, the bacteria can spread to nearby bones. Similarly, an open fracture (a broken bone that sticks out through the skin) can provide a route for bacteria to enter and infect the bone.

• During surgery: During procedures like joint replacement or fixing broken bones, there's a risk of bacteria entering the body. If this happens, the bacteria can travel to the bone and cause infection.

In short, while staph bacteria are normally harmless, they can become a serious threat if they gain access to a bone through the bloodstream, injury, or surgery.

Strong bones usually fight off infections. However, as we age, our bones become less able to fight off infections. This makes us more vulnerable to a bone infection called osteomyelitis. Several things can increase your risk:

Injuries and Medical Procedures:

• Wounds and surgery: Any break in the skin, like a deep cut or an operation, can create an entry point for germs to reach the bone.
• Medical tubes: Medical procedures that use tubes, like dialysis (which cleanses the blood when kidneys aren't working well), can introduce bacteria into the body. These tubes can carry germs from the outside world into the body.

Health Conditions:

• Weakened immune system: A weakened immune system makes it harder for your body to fight off infections. Poorly controlled diabetes is one example of a condition that can weaken the immune system.
• Peripheral artery disease (PAD): PAD narrows the arteries in your arms and legs, reducing blood flow. Reduced blood flow to the affected areas can make them more vulnerable to infection and slower to heal.
• Sickle cell disease: This inherited condition changes the shape of red blood cells, which can slow down blood flow throughout the body. Slower blood flow can make it harder for the body to deliver infection-fighting cells and oxygen to areas needing it.

Other Contributing Factors:

• Pressure injuries (bedsores): People who are unable to move or feel pressure, or who are confined to one position for extended periods, may develop sores on their skin. These pressure injuries can allow germs to enter the bone beneath. If these sores persist, the bone underneath can become infected.
• Illicit drug use with needles: Sharing needles or using unsterile needles to inject illicit drugs significantly increases the risk of osteomyelitis. Not properly cleaning the skin before injecting drugs also increases the risk of infection.

If you have any of these risk factors, it's important to talk to your doctor about ways to prevent osteomyelitis. Prompt treatment of any wounds, sores, or infections is crucial.

Osteomyelitis, a bone infection, can lead to several serious complications. Here's what to know:

• Bone Death (Osteonecrosis): When a bone infection occurs, it can stop blood from reaching parts of the bone. This lack of blood flow can cause the bone tissue to die. This is called osteonecrosis. If bone death happens, surgery is often needed to remove the dead tissue. This allows antibiotics to more effectively fight the infection.

• Joint Infection (Septic Arthritis): The infection from osteomyelitis can sometimes spread to a nearby joint, causing a joint infection called septic arthritis. This can lead to pain, swelling, and difficulty moving the joint.

• Growth Problems (in Children): If a child has osteomyelitis in the growth plates (the areas at the ends of long bones like arms and legs), it can affect their bone growth. These growth plates are softer and more vulnerable to the infection's impact.

• Chronic Osteomyelitis: Sometimes, osteomyelitis doesn't respond to treatment. This can lead to a long-lasting, or chronic, infection. Chronic osteomyelitis requires ongoing medical care and treatment to manage the infection effectively.

If you're more likely to get sick, talk to your doctor about ways to prevent infections. Preventing infections can also help prevent osteomyelitis.

Keep your skin healthy and avoid injuries. Cuts, scrapes, animal bites, and scratches are all openings that let germs enter your body. If you or your child gets a small cut or scrape, clean it right away. Put a clean bandage on it. Regularly check the wound for signs of infection, such as redness, swelling, warmth, or pus. If you notice any of these signs, contact your doctor.

Diagnosing Bone Infections (Osteomyelitis)

Doctors use several methods to diagnose osteomyelitis, a bone infection. They start by physically examining the area around the affected bone. They feel for any tenderness, swelling, or warmth, which could indicate the infection. If there's a sore on the foot, a tool called a dull probe might be used to see how close the sore is to the bone.

Next, various tests are performed to confirm the diagnosis and identify the specific germ causing the infection. These tests can include:

• Blood Tests: These tests look for high levels of white blood cells and other signs that the body is fighting an infection. While a blood test alone can't definitively diagnose osteomyelitis, it helps the doctor decide if further tests are needed. The blood test might also reveal which germ is causing the infection.

• Imaging Tests: These tests create pictures of the inside of the body. They're very helpful because the infection may not show up on X-rays for several weeks. Different imaging tests are available:

  • X-rays: X-rays can detect damage to the bone, but this damage might not be visible early on. More detailed tests might be needed if the infection is recent.
  • MRI (Magnetic Resonance Imaging): MRI uses strong magnets and radio waves to create detailed images of bones and the soft tissues around them.
  • CT (Computed Tomography) Scan: CT scans use X-rays from many angles to create detailed images of internal structures. If an MRI can't be done, a CT scan might be used instead.
  • Bone Scan: This test uses a small amount of radioactive material. Cells and tissues affected by infection absorb this material more readily, allowing the infection to be seen on the scan.

• Bone Biopsy: A bone biopsy is a procedure to take a small sample of bone tissue. This is done to identify the specific germ causing the infection. Knowing the germ type helps the doctor choose the best antibiotic treatment. There are two types of bone biopsies:

  • Open Biopsy: During an open biopsy, the patient is given a general anesthetic (medicine to make them sleep) and the doctor performs surgery to remove a sample of bone.
  • Needle Biopsy: A needle biopsy uses a long needle inserted into the bone under the skin. The area is numbed with a local anesthetic. Sometimes, imaging guidance (like X-rays) helps the doctor accurately place the needle.

By combining these different methods, doctors can accurately diagnose osteomyelitis and determine the best course of treatment.