Osteomyelitis is an infection of the bone. The infection may be:
- Acute—for a short time
- Chronic—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 specific bacteria.
Osteomyelitis is more common in males, or in young children and older adults. Other factors that increase your chance of osteomyelitis include:
- Trauma or injury to the bone and skin
- Broken bones, especially if open to or sticking through the skin
- Soft tissue infection
- Kidney dialysis
- IV drug use
- Weakened immune system
- Poor circulation
- Sickle cell anemia
- Any operation on a joint or bone, such as a hip replacement or internal fixation of a fracture
- Bone pain
- Fever or chills
- Tenderness, warmth, swelling, or redness of the skin or joint
- Drainage of pus
- Fatigue or irritability
- Restricted movement of the area
- A sore over a bone that does not heal
Skin Infection Spreading to Bone
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids and tissues may be tested. This can be done with:
- Blood tests
- Bone biopsy
Images may be taken of your bodily structures. This can be done with:
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 required to:
- Clean infected bone via scraping and irrigating the area
- Remove any fragments of dead bone or tissue that may prolong the infection
In severe cases, amputation may be necessary.
In some situations, your doctor may recommend a skin graft. The skin in the affected area is replaced with healthy skin taken from another part of your body.
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 quit .
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Foundation
The Canadian Orthopaedic Association
Carek PJ, Dickerson LM, Sack JL. Diagnosis and management of osteomyelitis. Am Fam Physician. 2001;63(12):2413-2420.
Osteomyelitis. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-osteomyelitis. Updated September 3, 2014. Accessed June 11, 2015.
Osteomyelitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 8, 2015. Accessed June 11, 2015.
Osteomyelitis. Nemours Kids Health website. Available at: http://kidshealth.org/en/teens/osteomyelitis.html. Updated October 2013. Accessed June 11, 2015.
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.