What is a bone infection (osteomyelitis)?
A bone infection, also called osteomyelitis, can result when bacteria or fungi invade a bone.
In children, bone infections most commonly occur in the long bones of the arms and legs. In adults, they usually appear in the hips, spine, and feet.
Bone infections can happen suddenly or develop over a long period of time. If they’re not properly treated, bone infections can leave a bone permanently damaged.
Types of Bone & Joint Infections
Osteomyelitis often occurs when an infection elsewhere in the body, such as a urinary tract infection or pneumonia, spreads through the blood to the bones. Sometimes, a recent surgery, an injection around a bone, or an open fracture—when a bone punctures the skin—can expose bone to bacteria, causing osteomyelitis.
Septic arthritis is the inflammation of a joint due to a bacterial or fungal infection. The condition occurs when a penetrating injury, such as a puncture wound, occurs near or above a joint, allowing bacteria to directly enter the joint. Bacteria can also spread through the bloodstream to a joint from a recent infection or after surgery.
It often affects the joints near long bones in the legs and arms. These include the hip, knee, and ankle joints and the shoulder, elbow, and wrist joints. The infection can also occur in the spine, pelvis, and heels.
Infants and older adults are most vulnerable to septic arthritis due to their anatomy and blood supply to the joints. The knee and hip are the most commonly affected joints in adults, whereas the hip is the most common site of infection in infants.
Septic arthritis can quickly cause severe damage to the cartilage and bone within a joint. Prompt treatment is critical for preventing permanent joint damage.
Symptoms are usually severe and include fever, redness, and swelling at the joint and intense pain that worsens with movement. In infants, symptoms may include a fever, the inability to move the limb with the infected joint, and crying when the infected joint is moved. For instance, infants with septic arthritis in a hip joint may cry when having a diaper change.
Many types of bacteria can cause bone and joint infections, including Staphylococcus aureus, also called staph, Enterobacter, and Streptococcus.
Causes of osteomyelitis?
Many organisms, most commonly Staphylococcus aureus, travel through the bloodstream and can cause a bone infection. An infection may begin in one area of the body and spread to the bones via the blood stream.
Organisms that invade a severe injury, deep cut, or wound can also cause infections in nearby bones. Bacteria can enter your system at a surgical site, such as the site of a hip replace mentor bone fracture repair. When your bone breaks, bacteria can invade the bone, leading to osteomyelitis.
The most common cause of bone infections is S. aureus bacteria. These bacteria commonly appear on the skin but don’t always cause health problems. However, the bacteria can overpower an immune system that’s weakened by disease and illness. These bacteria can also cause infections in injured areas.
What are the symptoms?
Usually, the first symptom to appear is pain at the infection site. Other common symptoms are:
- fever and chills
- redness in the infected area
- irritability or generally feeling unwell
- drainage from the area
- swelling in the affected area
- stiffness or inability to use an affected limb
Who is at risk for osteomyelitis?
There are a few conditions and circumstances that can increase your chances of osteomyelitis,
- diabetic disorders that affect blood supply to the bones
- intravenous drug use
- hemodialysis, which is a treatment used for kidney conditions
- trauma to the tissue surrounding the bone
- artificial joints or hardware that has become infected
- sickle cell disease
- peripheral arterial disease (PAD)
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How osteomyelitis diagnosed?
Your doctor may use several methods to diagnose your condition if you have any symptoms of a bone infection. They will perform a physical exam to check for swelling, pain, and discoloration. Your doctor may refer lab and diagnostic tests to determine the exact location and extent of the infection.
It’s likely your doctor will refer blood tests to check for the organisms causing the infection. Other tests to check for the bacteria are throat swabs, urine cultures, and stool analyses. The stool culture is an example of a stool analysis.
Another possible test is a bone scan, which reveals the cellular and metabolic activity in your bones. It uses a type of radioactive substance to highlight the bone tissue. If the bone scan doesn’t provide enough information, you may need an MRI scan. In some cases, a bone biopsy may be necessary.
However, sometimes a simple bone X-ray may be enough for your doctor to determine the treatment that’s right for you.
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