Osteomyelitis is an infectious condition of the bone, affecting the arms, feet, hips, legs & spine.
The condition is usually more common in children but can occur in adults too.
CLASSIFICATION OF OSTEOMYELITIS
- 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, inflammatory condition that arises from reaction to dental related infection)
- Proliferative periostitis (periostitis ossificans)
- Osteoradionecrosis, serious complication of radiation therapy.
SIGNS & SYMPTOMS
- Pain in the bone
- Inflammation of the bone
- Tenderness, redness & warmth in the localized infected area.
- Swelling around the bone
- Back pain/especially in the night
- Gradual or sudden onset of fever.
- Fatigue & irritability
- Enlarged lymph nodes
- Limited range of motion
COMPLICATIONS ARISING FROM OSTEOMYELITIS
- Arthritis in children
- Garre’s sclerosing osteomyelitis
- Sclerosis, hardening of the tissue surrounding the bone.
- Amputation & removal of infected bone in severe cases.
- The infection most commonly occurs in children younger than 4 years old.
- Bacteria that cause the infection are;
- S Aureus
- Haemophilus influenzae
- Group A Streptococcus
- Salmonella in people that have sickle cell anemia
- Also some fungi that can infect the bones.
- Compromised host resistance
- Intravenous drug abuse
- Infected teeth that have undergone root canal surgery.
- Drugs like immunosuppressive drugs that can weaken the immune system.
- Long term use of steroids.
- Sickle Cell Anemia
- HIV or AIDS
- Rheumatoid Arthritis
- Poor blood supply to the bones
- Trauma or fracture of the bones.
- Prior removal of the spleen.
- Laboratory marker tests that detect high WBC count & fever, although imaging tests along with it are also necessary for confirmation.
- CT scans can show the superficial damage to the bones in advanced osteomyelitis.
- MRI scans done show the damage to the cortical structure of the bone & bone marrow, similarly the presence of edema/fluid accumulation is also detected.
- For patients that may have metal implants and cannot undergo MRI, a contrast medium can be injected for imaging.
- Nuclear medicine procedures that utilize Gallium for contrasting are useful for effective diagnosis of the damage & infection to the bone.
- Culture or biopsy of the bone are also taken by sampling methods for distinguishing between the different pathogens that cause osteomyelitis.
TREATMENT & MANAGEMENT FOR OSTEOMYELITIS
- Antibiotic therapy for weeks or even months.
- Long term IV administration of medicine through a catheter.
- Hyperbaric oxygen therapy in patients with refractory osteomyelitis.
- In severe conditions, surgery is performed to removed dead tissue & amputation of the infected bone & joints.
- Calcium supplements
- Prevention is by treating deep wounds, disinfecting them, use of antibiotics & covering them.