Osteomyelitis refers to a bone infection, usually caused by a bacteria. This can result in the destruction of the bone itself. It can be characterized as:

  • Acute Osteomyelitis
  • Chronic Osteomyelitis

It is further classified as:

  • Suppurative osteomyelitis
  • Acute suppurative osteomyelitis
  • Chronic suppurative osteomyelitis
  • Primary (no preceding phase)

Secondary (follows an acute phase)

  • Non-suppurative osteomyelitis
  • Diffuse sclerosing
  • Focal sclerosing (condensing osteitis)
  • Proliferative periostitis (periostitis ossificans, Garré's sclerosing osteomyelitis)
  • Osteoradionecrosis

References: www.nhs.uk

The most common symptoms are bone pain and high fever:

Acute osteomyelitis:
The symptoms of acute osteomyelitis include:

  • High temperature (fever) of 38°C (100.4°F) or above
  • Bone pain, which can often be severe
  • Swelling, redness and warmth at the site of the infection
  • The affected body part is tender to touch
  • The range of movement in the affected body part is restricted
  • Lymph nodes (glands) near the affected body part may be swollen

Symptoms of chronic osteomyelitis:
In cases of chronic osteomyelitis, symptoms usually recur that have been experienced during a previous infection. Symptoms can flare up at any time:

  • Bone pain
  • Feeling persistently tired
  • Pus draining from the sinus tract (a passageway that develops near the infected bone)
  • Local swelling
  • Skin changes
  • Excessive sweating
  • Chills

Reference: www.nhs.uk

It is generally caused due to bacteria especially staphylococcus aureus.
It is generally seen in children and if it is seen in adults it is due to:

  1.  Compromised immunity.
  2.  Secondary infection with pulmonary tuberculosis.

Reference: www.nlm.nih.gov

Physical examination
To confirm a diagnosis of osteomyelitis, doctor may carry out a physical examination of affected body part to check for redness, swelling and tenderness.

Blood test
Patient is also referred for a blood test. This cannot confirm osteomyelitis, but can indicate infection by number of white blood cells in the blood.

Imaging tests
If osteomyelitis is suspected, further imaging testing may be conducted. There are several imaging tests that may be able to detect bone damage caused by osteomyelitis. They include:

  • X-rays, where low levels of radiation are used to create an image of the affected bone. Though this test is not usually useful for diagnosis if the condition is in the early stages.
  • Magnetic resonance imaging (MRI) scan, where a strong magnetic field and radio waves are used to build up a picture of the inside of the affected bone.
  • Computerized tomography (CT) scan, where a series of X-rays of your affected bone are taken and a computer is used to assemble them into a more detailed three-dimensional image.
  • Ultrasound scan, where high-frequency sound waves are used to create an image of the affected bone to highlight any abnormalities

If earlier testing suggests osteomyelitis, it is usually necessary to remove a small sample of bone for further testing. This is known as a biopsy. A biopsy is usually necessary to confirm a diagnosis of osteomyelitis and can help establish the exact type of bacteria or fungus causing your infection. This can be very useful when deciding on the most effective treatment. A biopsy is usually combined with surgery in chronic cases.

Reference: www.nhs.uk

In Acute cases: Antibiotics are used as successful line of treatment.

In Chronic cases: With antibiotics and surgery are used as combination therapy. Surgery may be used to remove bone, to drain pus from a wound or abscess, or to remove and replace a joint replacement if it was the cause of infection.

Hyperbaric oxygen therapy: Non-surgical treatment called hyperbaric oxygen therapy may be useful in treating cases of both acute and chronic osteomyelitis that do not respond to conventional treatment.

References: www.ncbi.nlm.nih.gov

  • LAST UPDATED ON : Sep 16, 2015


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