Bone infection

Osteomyelitis is the medical term for a bone infection, usually caused by bacteria.

Osteomyelitis most commonly affects the long bones in the legs, but other bones, such as those in the back or arms, can also be affected.

Symptoms of osteomyelitis may include:

• a high temperature (fever) of 38C (100.4F) or above
• bone pain, which can often be intense
• swelling, redness and a warm sensation in the affected area 

Read more about the symptoms of osteomyelitis.

The condition is often referred to as either:

• acute osteomyelitis – when the infection develops following an injury, infection or underlying condition
• chronic osteomyelitis – when the condition regularly returns

When to see your GP

Osteomyelitis can affect people of any age, so visit your GP if you or your child experiences persistent bone pain with a fever.

Very young children do not always develop a fever when they have osteomyelitis and they may not be able to communicate any bone pain. You should see your GP if your child becomes irritable, has a reduced appetite and is reluctant to use a certain part of their body (most often an arm or leg).

Why does osteomyelitis happen?

Osteomyelitis develops when the bone becomes infected. In most cases, bacteria is responsible for the infection, although it can also be caused by fungi.

Blood tests and a biopsy may be used to determine whether you have an infection and what caused it.

Read more about diagnosing osteomyelitis.

There are two ways the infection can occur:

• following an injury (known as contiguous osteomyelitis) – such as a fractured bone, animal bite or during surgery
• via the bloodstream (known as haematogenous osteomyelitis)

Contiguous osteomyelitis is more common in adults, whereas haematogenous osteomyelitis is more common in children.

Certain things can increase your chances of developing osteomyelitis. For example, if you have a condition that affects the blood supply to certain parts of your body, such as diabetes, or a condition that weakens the immune system, such as rheumatoid arthritis.

Osteomyelitis is also known to be a common complication of certain health conditions. For example:

• 30-40% of people with diabetes who experience a puncture injury to their foot will develop osteomyelitis
• less than one in every 200 people with sickle cell anaemia will develop osteomyelitis in any given year

Osteomyelitis can become chronic osteomyelitis if not treated quickly, as the bones can become permanently damaged, resulting in persistent pain and loss of function.

Read more about the causes of osteomyelitis.

How is osteomyelitis treated?

If diagnosed early, osteomyelitis can be treated with antibiotics for at least four to six weeks. At first, you may have to stay in hospital to receive antibiotics, but you should be able to take them at home when you start to get better.

In severe or chronic cases of osteomyelitis, surgery may be used in combination with antibiotics. Surgery is most often used to remove damaged bone and drain pus from wounds.

Read more about treating osteomyelitis.

Complications

Although osteomyelitis is usually treated successfully with antibiotics, chronic and severe cases can lead to other problems.

Recurring osteomyelitis

If you've had a previous episode of osteomyelitis, there's a chance of it returning. This is because underlying conditions that often cause osteomyelitis, such as poor circulation or a weakened immune system, can be difficult to treat.

Gangrene

If the blood supply to the bone is severely reduced, this can cause the tissue to die (gangrene). Amputation may be used as a last resort if gangrene develops.

However, the condition can usually be treated before it reaches this stage.

Preventing osteomyelitis

It's not always possible to avoid getting osteomyelitis. But there are steps you can take to reduce your chances.

Cleaning wounds thoroughly with water and dressing them in a clean bandage will reduce your chances of getting an infection from an injury.

Improving your general health will help reduce the risk of developing conditions that can lead to osteomyelitis.

Read more about preventing osteomyelitis.