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Osteomyelitis

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The disease that affects the bone marrow is called as osteomyelitis.  This condition can affect any bone in the body, but mostly occurs in the long bones of  the arm and leg. Adults usually develop osteomyelitis of the spine.

Overview

Osteomyelitis is inflammation of the bone marrow due to an infection. It is a very rare condition that occurs when infection from other parts of the body spread to the marrow. Bone injury or fracture can lead to spreading of infection directly into the marrow. This causes inflammation of marrow. This swelling of the marrow compress the surrounding blood vessels. The compression affects the blood flow, leading to bone cell death. Osteomyelitis was supposed to be an incurable condition. However, with advancement in medical science, today osteomyelitis is easily treatable.

Causes

A bone infection leads to osteomyelitis. There are many ways that can lead to a bone infection. Infection can spread to the bone marrow by:

  • Bone injury that causes fractures
  • Infection of soft tissues that spreads to the marrow
  • Infection travelling in the blood can reach the bone
  • Chances of infection high in case of diabetes
  • Bone surgery can introduce an infection into the marrow
  • Placing an artificial joint into the bone can also lead to infection of the surrounding tissue
  • Placement of metal rods to heal bone fractures can also lead to infection
  • Bacteria or other infectious agents present on the skin can spread to the bone during a surgery or an injury that causes the bone to protrude out
  • Kidney dialysis increases the risk of osteomyelitis
  • People using banned drugs have a higher risk of osteomyelitis
  • Pott’s disease, a condition where TB bacteria infect the bones can lead to osteomyelitis
  • People with rheumatoid arthritis, sickle cell disease are more prone to osteomyelitis

The infection causing agents that lead to osteomyelitis commonly includes bacteria as well as fungus in some cases. The common bacterial agents that lead to inflammation of the bone marrow include:

  • Staphylococcus aureus
  • Streptococcus group A and group B,
  • H. influenza
  • Coliforms
  • Pseudomonas aeruginosa

Symptoms

Signs and symptoms of osteomyelitis include:

  • Swelling and tenderness around the infected area
  • Pain in the infected bone
  • Infected area feels warm to touch
  • Nausea
  • Fever, chills, excessive sweating
  • Pus formation or abscess
  • Lower back  pain in case of spinal osteomyelitis
  • Limping or change in gait due to involvement of long bones of the legs
  • Lethargy
  • Irritability

Diagnosis

Diagnosis is based on signs and symptoms observed like swelling, bone tenderness, redness, etc. Certain tests will be carried out like:

  • Complete blood count, erythrocyte sedimentation rate, etc. to check for an increase in WBC count or inflammation in the body
  • Blood culture to check for bacterial infection
  • Tissue biopsy to check for infection of bone
  • Bone scan to detect abnormalities within the bone

Treatment

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Treatment aims to prevent further spread of bone infection and eliminate the infection completely. Some of the treatments include:

  • Needle aspiration procedure is carried out to drain the abscess or pus pocket present in the area of infection
  • Medications prescribed that help fight the bacterial infection. These antibiotics are given intravenously as well as orally.
  • Surgery to remove the affected bone or tissue.
  • Bone or tissue graft is carried out to help regrowth of new bone and blood vessels damaged or removed
  • In extreme cases, amputation of the limb is the only option.
  • Hyperbaric oxygen therapy helps in delivering oxygen to the affected bone to promote quick healing.

Prognosis

Proper treatment helps in the healing of the infection and curing the patient. However, in case of chronic osteomyelitis, when none of the treatments work, amputation is the only cure. With the modern treatments available, amputation is now a rare procedure and most patients are successfully treated of osteomyelitis.

Prevention

Certain steps will ensure that osteomyelitis is prevented, especially in cases where the bone is vulnerable to infection. These steps include:

  • In case of injury, make sure you clean the site thoroughly and wrap it with a clean cloth or bandage till medical help is sought.
  • Maintain a healthy diet to improve the immune system and reduce risk of infections.
  • Quit smoking and limit your alcohol intake.
  • Exercise regularly and maintain a healthy weight. This will ensure your blood pressure stays in control and blood circulation remains unaffected.
  • Keep your blood sugar level in control as diabetes makes one more to developing serious infections.
  • Any ulcers, injury, infections or swelling that does not heal, should be brought to the notice of a doctor immediately.

Osteomyelitis is a rare condition, that can turn serious, if left untreated. Make sure you follow the doctors advice and get treatment as soon as possible.

Written by: Saptakee sengupta
Date last updated: February 27, 2015