Osteomyelitis is an infection of the bone. It's a rare disease, and it can be serious.
It can occur when bacteria (or less commonly, fungi) enter the body through a wound, surgical incision, or diabetic foot ulcer.
Doctors treat osteomyelitis with medications and, in some cases, surgery. UPMC orthopaedic, wound care, and infectious disease specialists work together to deliver personalized care for people with osteomyelitis, using the latest techniques and treatments.
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What Is Osteomyelitis?
Osteomyelitis is a painful bone infection. Osteomyelitis is a rare condition that can cause serious complications if left untreated.
What are the types of osteomyelitis?
There are two types of osteomyelitis, including:
- Acute osteomyelitis — The most common type of osteomyelitis, which causes symptoms that come on quickly. Most people diagnosed with acute osteomyelitis are children, but it can also affect adults.
- Chronic osteomyelitis — Symptoms last more than six weeks and may come and go for months or years. Adults with diabetes, chronic vascular disease, or weakened immune systems are more likely to have chronic osteomyelitis.
How common is osteomyelitis?
Osteomyelitis is a rare condition. The National Organization for Rare Disorders estimates that 2-5 out of 10,000 people in the U.S. develop osteomyelitis each year.
What causes osteomyelitis?
Osteomyelitis forms when an infection from bacteria or fungi spreads to the bone. Most often, the cause is a staph infection. These germs live on the skin of even healthy people but can cause bone infection in people who have open wounds or sores and weakened immune systems.
Bacteria can enter the bone through:
- Injuries — A traumatic injury (such as a puncture wound) may let germs travel deep into the body.
- IV lines or catheters — Medical tubing can be a pathway for germs to enter your body through the blood and, in time, cause a bone infection.
- Surgery — There's a chance of infection with joint replacement surgery or any other surgery that involves bones or joints.
- The bloodstream — Germs can sometimes travel through the blood from an infection site to a weak or damaged part of the bone.
Osteomyelitis risk factors
Osteomyelitis affects men and women equally and can occur at any age, but often happens in:
- People with diabetes.
- Preschool-age children.
- The elderly.
You're at greater risk for osteomyelitis if you:
- Are having dialysis for chronic kidney failure.
- Have a weakened immune system.
- Have diabetes, especially if it causes foot ulcers.
- Have had a recent traumatic bone or joint injury.
- Have had bone or joint surgery (such as a hip replacement).
- Have pressure injuries (bedsores).
- Inject illicit drugs.
Complications of osteomyelitis
If left untreated, complications of osteomyelitis may include:
- Bone death — If an infection cuts off blood flow to the bone, it will weaken and eventually break down. Surgery may then be needed to remove affected parts.
- Bone fractures — The infection weakens the bone, making it more prone to fractures.
- Septic arthritis — The infection can spread from the bone into an adjacent joint, causing it to become painful, swollen, and warm to the touch.
- Skin cancer — Untreated osteomyelitis can, in rare cases, lead to squamous cell carcinoma, a type of skin cancer.
How can I prevent osteomyelitis?
You may not be able to prevent osteomyelitis, but you can take steps to lower your risk, including:
- Clean any wound thoroughly — Bacteria enter the body through open wounds. Flush any open wound with water for five minutes before bandaging and see a doctor for severe wounds.
- Manage your diabetes and monitor your feet and lower legs — Controlling your blood sugar may reduce your risk of developing diabetic foot ulcers. Pay careful attention to your feet and call your doctor at the first sign of infection.
What Are the Signs and Symptoms of Osteomyelitis?
In children, osteomyelitis usually occurs in the long bones of the arms or legs. In adults, it's most often in the spine, feet, or hips.
Symptoms of osteomyelitis include:
- An open wound that's draining pus.
- Bone pain without any clear cause.
- Fever and chills.
- New, refractory, or worsening back pain.
- Swelling, redness, or warmth of a joint.
- Ulcers with visible bone present.
When should I see a doctor about my osteomyelitis symptoms?
If you have osteomyelitis symptoms, you should schedule an appointment with your doctor as soon as possible. Early diagnosis and treatment can improve your chances of recovery and reduce your risk of complications.
How Do You Diagnose Osteomyelitis?
To diagnose osteomyelitis, your doctor will perform a physical exam and review your symptoms and medical history. Your doctor may also order tests to help make a diagnosis.
What to expect during your visit
To diagnose osteomyelitis, your doctor will:
- Ask about any recent medical procedures, chronic diseases, and any history of illicit drug use.
- Ask about your symptoms and medical history.
- Do a physical exam, focusing on bone tenderness or swelling.
- Order tests to confirm the diagnosis.
Tests to diagnose osteomyelitis
Tests to diagnose osteomyelitis may include:
- Blood cultures — Checks for organisms in the blood that might be causing infection.
- Bone biopsy — Takes samples of involved bone or tissue that may show signs of infection for analysis in the lab.
- Bone scan — A nuclear imaging test that uses a radioactive tracer to show bone abnormalities.
- Complete blood count (CBC) — Checks for signs of inflammation and infection.
- Imaging scans — Creates images of your bones, tissues, and muscles.
Osteomyelitis prognosis
Most cases of acute osteomyelitis can be successfully treated. Chronic osteomyelitis is more challenging to treat — especially in people with diabetes, poor circulation, or weakened immune systems — and symptoms may come and go for months or years. Your prognosis also depends on your overall health, the severity of your infection, and other factors.
How Do You Treat Osteomyelitis?
The doctors at UPMC are experts at treating acute and chronic osteomyelitis. Their goal is to treat the infection, eliminate symptoms, and reduce bone damage.
Treatment options may include:
Medications
Your doctor may prescribe medications to treat osteomyelitis, including:
- Antibiotics — You'll likely need at least 4-6 weeks of antibiotics to kill the bacteria that caused the bone infection. Based on your condition, you may need to continue taking them for weeks or months.
- Antifungals — If fungi caused your osteomyelitis, your doctor will give you either oral or IV antifungal drugs. You may need to take this medicine for several weeks or months.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) — Your doctor may give you NSAIDs to help with pain and inflammation as needed.
Wound care
If you have a diabetic foot ulcer or nonhealing wound that is causing chronic osteomyelitis symptoms, our team will provide comprehensive wound care to promote healing and reduce the risk of osteomyelitis recurrence or complications.
Procedures
Procedures to treat osteomyelitis may include:
- Needle aspiration — If you have an abscess, your doctor may drain the pus with a fine needle.
- Surgery — You may need surgery to help control your osteomyelitis. Surgery prevents the infection from spreading further and reduces the likelihood that you will require amputation.
Why Choose UPMC for Osteomyelitis Care?
When you choose UPMC for osteomyelitis care, you will receive:
- Access to board-certified specialists — Our multidisciplinary team of experts provides leading-edge, minimally invasive orthopaedic, infectious disease, and wound care for people with osteomyelitis.
- Expert diagnosis and personalized care — Our team will develop a customized treatment plan to reduce your risk of complications and improve your quality of life.
- A full range of treatment options — We use the latest therapies and approaches to provide comprehensive care, including personalized wound care and infectious disease treatments.
