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The Facts Put Simply

Learn About Osteomyelitis and Equip Yourself to Fight Back!

Subject matter Quick Links for this page…

1) What Is Osteomyelitis?
2) Osteomyelitis Facts
3) Who is at risk to get Osteomyelitis?
4) Causes of Osteomyelitis
5) Symptoms of Osteomyelitis
6) What can you do to prevent Osteomyelitis?
7) What can you do to combat Osteomyelitis?

What Is Osteomyelitis?

Osteomyelitis is an infection of the bone which is usually caused by the introduction of bacteria into the bone by a variety of means.

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Osteomyelitis facts:

• Can affect both adults and children
• Affects about two out of every 10,000 people
• If left untreated, the infection can become chronic (long term/recurring) and cause a loss of blood supply to the affected bone. When this happens, it can lead to the eventual death of the bone tissue.
• Chronic osteomyelitis can lead to permanent deformity and chronic problems
• In adults, osteomyelitis often affects the vertebrae and the pelvis
• Spinal osteomyelitis is more common in persons older than 45 years
• In children, osteomyelitis usually affects the adjacent ends of long bones. Long bones are large, dense bones that provide strength, structure, and mobility. They include the femur and tibia in the legs and the humerus and radius in the arms.

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Who is at risk to get Osteomyelitis?

• Males are twice as likely to contract it than are females
• Osteomyelitis does not occur more commonly in a particular race or gender. However, some people are more at risk for developing the disease, including:

o People with diabetes
o Patients receiving hemodialysis
o People with weakened immune systems
o People with sickle cell disease
o Intravenous drug abusers
o The elderly

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Causes of Osteomyelitis?

• It can be caused by a variety of microbial agents and situations including:
o An open injury to the bone, such as an open fracture with the bone ends piercing the skin
o An infection from elsewhere in the body, such as a urinary tract infection that has spread to the bone through the blood
o A minor trauma, which can lead to a blood clot around the bone and then a secondary infection from seeding of bacteria
o Bacteria in the bloodstream, which is deposited in a focal (localized) area of the bone. This bacterial site in the bone then grows, resulting in destruction of the bone. However, new bone often forms around the site
o A chronic open wound or soft tissue infection can eventually extend down to the bone surface, leading to a secondary bone infection.
• The bacteria or fungus that can cause osteomyelitis, however, differs among age groups.

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Symptoms of Osteomyelitis:

• Pain and/or tenderness in the infected area
• Swelling and warmth in the infected area
• Fever
• Nausea, secondarily from being ill with infection
• General discomfort, uneasiness, or ill feeling
• Drainage of pus through the skin

Additional symptoms that may be associated with this disease include:
• Excessive sweating
• Chills
• Lower back pain
• Swelling of the ankles, feet, and legs
• Changes in gait (walking pattern that is a painful, yielding a limp)

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What can you do to prevent osteomyelitis?

Osteomyelitis results from an infection from any part of the body, migrating to a bone or joint which can be local to or remote from the initial site of the infection. As such, quick attention to resolving infections is key. This will limit the chance of the infection spreading. High-risk groups should see a health care provider immediately if signs of an infection anywhere in the body arise.

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What can you do to combat osteomyelitis?

The objective of treatment is to eliminate the infection and prevent the development of chronic infection. Chronic osteomyelitis can lead to permanent deformity and chronic problems, so it is important to treat the disease as soon as possible.

• If there is an open wound or abscess, it may be drained through a procedure called needle aspiration. In this procedure, a needle is inserted into the infected area and the fluid is withdrawn. Deep aspiration is preferred over often-unreliable surface swabs.
• Prescribing antibiotics is the first step in treating osteomyelitis. Antibiotics help the body get rid of bacteria in the bloodstream that may otherwise re-infect the bone. The dosage and type of antibiotic prescribed depends on the type of bacteria present and the extent of infection. While antibiotics are often given intravenously, some are also very effective when given in an oral dosage. It is important to first identify the offending organism through blood cultures, aspiration, and biopsy so that the organism is not masked by an initial inappropriate dose of antibiotics.
• Splinting or cast immobilization may be necessary to immobilize the affected bone and nearby joints in order to avoid further trauma and to help the area heal adequately and as quickly as possible. Splinting and cast immobilization are frequently done in children, although motion of joints after initial control is important to prevent stiffness and atrophy.
• Surgery: Most well-established bone infections are managed through open surgical procedures during which the destroyed bone is scraped out. In the case of spinal abscesses, surgery is not performed unless there is compression of the spinal cord or nerve roots. Instead, patients with spinal osteomyelitis are given intravenous antibiotics. After surgery, antibiotics against the specific bacteria involved in the infection are then intensively administered during the hospital stay and for many weeks afterward.

With proper treatment, the outcome is usually good for osteomyelitis, although results tend to be worse for chronic osteomyelitis, even with surgery. Some cases of chronic osteomyelitis can be so resistant to treatment that amputation may be required; however, this is rare. Also, over many years, chronic infectious draining sites can evolve into a squamous-cell type of skin cancer, although this, too, is rare.

Any change in the nature of the chronic drainage, or change of the nature of the chronic drainage site, should be evaluated by a physician experienced in treating chronic bone infections.

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