Osteomyelitis is an infection of the bone. The infection may be: Acute—for a short timeChronic—lasting for a long time
In adults, the pelvis and the bones of the back are the most common sites. In children, the long bones are most likely to be affected. These are found in the arms and legs.
Osteomyelitis is caused by bacteria that comes in contact with bone tissue and begin to grow. The bacteria may reach the bone through: Bloodstream—blood can carry bacteria from an infection in another part of the bodyDeep cut that exposes the bone to bacteria on the surface of the skin or environmentAn infection in a nearby tissue, such as a skin ulcer
Osteomyelitis is more common in adolescents and young adults. Other factors that increase your chance of osteomyelitis include: Poor circulation from disorders such as diabetes or peripheral vascular disease—slows healing and increase risk of infectionTrauma
or injury to the bone and skin
Recent surgery on a joint or bone, such as a
or internal fixation of a fracture
Soft tissue infectionWeakened immune system
drug useCatheter usePressure ulcers
Symptoms include: Bone painFever or chillsTenderness, warmth, swelling, or redness of the skin or jointDrainage of pusNauseaWeight lossFatigue or irritabilityRestricted movement of the areaA sore over a bone that does not heal
Skin Infection Spreading to Bone
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You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids, tissues, and bones may be tested to look for signs of infection. This can be done with: Blood testsSkin wound culturesBone biopsy
Images may be taken of the affected bone to look for abnormalities. This can be done with: X-rayMRI scanCT scanBone scanPET/CT scan
The affected area may be treated with a splint to prevent it from moving. Avoiding weight bearing activities may also be advised.
The infection is treated with antibiotics. They are given by IV and sometimes by mouth. Acute osteomyelitis is generally treated for at least 4-6 weeks. Chronic osteomyelitis may require antibiotics for a longer period of time.
Surgery may be needed to remove dead tissue and bone.
In some situations, a
skin graft may be needed
to replaced removed tissue and close the wound. The skin in the affected area is replaced with healthy skin taken from another part of the body.
In severe cases,
may be necessary.
To reduce your chance of osteomyelitis: Seek immediate medical care for infections or injuries.Keep diabetes under control.Do not use illegal drugs.See your doctor for any sores that do not heal.
If you smoke, talk to your doctor about how you can successfully
Carek PJ, Dickerson LM, Sack JL.
Diagnosis and management of osteomyelitis.
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Osteomyelitis. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-osteomyelitis. Updated September 3, 2014. Accessed January 19, 2017.
Osteomyelitis. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/infections-of-joints-and-bones/osteomyelitis. Updated October 2014. Accessed January 19, 2017.
Osteomyelitis. Nemours Kids Health website. Available at:
http://kidshealth.org/en/teens/osteomyelitis.html. Updated October 2013. Accessed January 19, 2017.
Osteomyelitis. Patient UK website. Available at: http://patient.info/health/osteomyelitis-leaflet. Updated August 11, 2016. Accessed January 19, 2017.
Last reviewed May 2016 by David L. Horn, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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