Osteomyelitis

Osteomyelitis is an infection of bone caused by bacteria that may result in the death of bone tissue. This infection may reach the bone by traveling through the bloodstream or spreading from nearby tissue. Here are all the answers to all the questions you ever had about osteomyelitis by our expert Dr. Suneel Kumar, senior consultant, Orthopedics and Joint Replacement, Delhi based Sri Balaji Action Medical Institute.

Causes

The bone infection is usually caused by bacteria called Staphylococcus aureus. They occur when bones are infected by blood-borne bacteria. Sometimes tuberculosis might affect bones as well. Certain chronic conditions like diabetes increase the risk of osteomyelitis.

Risk factors

The condition of osteomyelitis can affect both children and adults but in different ways. While children are prone to develop bone infections in their arms and legs from an infection carried from another part of the body through the blood, adults tend to develop infections in their spinal bones (spinal vertebrae).

Meanwhile, there are certain conditions like diabetes, sickle cell disease, HIV or AIDS, rheumatoid arthritis, drug intake, alcoholism, use of steroids that weaken the immune system of a person, increasing the risk for osteomyelitis.

Symptoms

If one starts experiencing tenderness and bone pain besides high fever, there is a risk of osteomyelitis. A lump may develop over a bone, which is usually very tender. If osteomyelitis develops following a bone fracture, then one will see increasing redness, swelling, and pain around the fracture site.

In case a child develops a high fever and persistent bone pain, it is advisable to visit the orthopedic surgeon immidiately.

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Diagnosis

To diagnose a suspected osteomyelitis, a physical examination of the affected body part is done to check for redness, swelling and tenderness. Blood test can also be done to check the number of white blood cells in blood, which may suggest the presence of an infection.

A patient will also need to go through imaging, have an X-ray and an MRI scan. Once the testing suggests osteomyelitis, it is usually necessary to remove a small sample of bone for further testing termed as biopsy. In osteomyelitis a doctor will find pus in the bone, this pus is drained and sent for examination to determine the type of bacteria causing the infection.

Treatment

In certain cases, osteomyelitis can be effectively treated with antibiotics and pain medications. However, the best possible antibiotics and treatment for each patient depends on the causative organism through a culture of the pus. The antibiotics are usually administered through a vein in the arm for at least four to six weeks. If the infection gets severe, a surgery is performed.

There are procedures that include draining the infected area, removing the diseased bone and tissue and restoring the blood flow to the bone. Meanwhile, people who suffer from very difficult-to-treat osteomyelitis are advised to go through a course in a hyperbaric oxygen chamber as a form of treatment. This helps the person get more oxygen, thereby providing it to the bone and promotes healing.