Osteomyelitis 

Introduction 

Who is affected?

There is limited information about how widespread osteomyelitis is in the UK. However, in England, around 5,000 adults and children visit hospital for osteomyelitis each year.

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

Symptoms of osteomyelitis may include:

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

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.

Read more about the symptoms of osteomyelitis.

The condition is often referred to as acute osteomyelitis when the infection develops following an injury, infection or underlying condition. It's referred to as chronic osteomyelitis when the condition regularly returns.  

When to see your GP

Osteomyelitis can affect people of any age, so you should 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 that they have 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 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?

Osteomyelitis is usually treated with antibiotics, used for at least four to six weeks. At first, you may have to receive this while staying in hospital, 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

Osteomyelitis usually responds well to antibiotics. However, for people with underlying conditions which increase the risk of osteomyelitis, such as diabetes, there is a chance the infection could come back.

As a last resort, amputation is sometimes used if the blood supply to the bone is severely reduced. However, these days it is highly unlikely this will be necessary, as the condition can usually be treated before it reaches this stage.

Read more about the complications of osteomyelitis.

Preventing osteomyelitis

It is not always possible to avoid getting osteomyelitis, however, 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 osteomyelitis or another condition that causes high blood pressure or a weakened immune system.

Read more about preventing osteomyelitis.




Page last reviewed: 18/10/2012

Next review due: 18/10/2014

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Comments

The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Janet148 said on 08 March 2014

I had chronic osteomyelitis when I was 6 weeks old (am now 35) and had surgery on my left femur, of which i still have a 6 inch scar there. My parents were sure that I caught the infection through my belly button as it didn't heal properly after I was born

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electriceel said on 28 November 2013

I was diagnosed with Osteomyelitis in my Femur when I was 5 years old in the 1960's
I think that the original trigger was a hard knock to the leg, from falling off a wall.

The initial consultant had recommended amputation, but a second opinion was sought by my parents (phew!) and I was pumped full of injections of a new fangled antibiotic oxy-tetracyclin, which eventually sorted it out.

I spent over 6 months in hospital which included an operation to drain the infection and extra time for when they first let me out of bed and I slipped on my long pyjamas managing to break the weakened femur.

For approx. 12months after discharge, I was made to wear a metal leg brace for support.

Beware, the infection can return...... which it did when I was 9yrs and 11yrs old. Both times caused by contact sports.

The second occasion resulted in an abcess in the same leg but nearer the knee joint. This burst by itself and yielded some bits if bone like well sucked slivers of Blackpool Rock!
The third occasion, pain and temperature were present, but antibiotics cleared it up pretty rapidly.

As stated correctly in the article, the pain from an osteomyelitis infection can be horrendous, like a nagging toothache within the bone, all the time!

It seems to be in my case that the older I became, the more resilient I became to this infection. Quite a few times I had the typical osteomyelitis start-up pain, but I think my body was able to fight it off.

I was barred from playing sports throughout most of my time at school, due the risk of the condition returning, but I was allowed to swim as this was regarded as good exercise.
From the age of about 15, I never suffered any more from it.
I still have a large depression at the back of my femur where the initial infection was drained, and also a small depression just above my knee joint which is very sensitive to pressure if pressed as there is little flesh and muscle between the skin and the bone itself.

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cohe2005 said on 19 July 2013

I don't know if anyone is still looking at these comments,but I just found this site and read it all. I thought my story might interest some people. I am 42 years old and have diabeties, i have had it since 1994,but after reading the story about osteomyelitis it got me thinking, i had osteomyelitis when I was 3 years old, i spent 11 months in Gobowen hospital and had 32 operations on my left leg (I was told 32 by my parents) I have 2 very large scars on my left leg from just under the knee to the bottom of my ankle. Do I have diabeties because of osteomyelitis? It looks like it normally happens the other way around, i was told told years later I was the youngest person at the time that had it in the uk (not sure about that). I was born in hong kong in 1971 (father in army) and was told I had an infection a bit later, is it possible I have diabeties because of osteomyelitis? Diabeties is not in my family. This is very interesting to me and if some expert knows I would love to know (possibly so I can stop worrying about my kids). Any info would be gratefull. Many thanks.

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antdom said on 17 May 2012

Antony Hayman
I developed acute Osteomylitis of the femur in 1940. I had the usual treatment at that time and. Had my leg encased in plaster for around 9 months during which it continued to exude pus. One of the medicines I was given at that time was M&B 693'one of the new sulpanimidedrugs.
Discharged from hospital after one year I continued to dress my leg until 1946. During this time the disease broke out on my left clavicle. Following my army medical I went into the Middlesex Hospital in Mortimer st. There I was operated on by a marvellous surgeon. Millions of units of Penicillin later I was cured.

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Speigal said on 22 April 2012

I had this condition when I was 11. I was in hospital for 3 months and was treated with pencillion injections every 6 hours morning and during the night and I was given vitamin powder on a spoon it was disgusting but part of the treatment this was 1954 after all. It never had a cause pinned to it and I recovered and did not suffer any long term affects.

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luckylad said on 25 August 2011

I had chronic osteomyelitis of my lower right leg which resulted in surgery with the removal of approx 2 inches of my shin bone. Obviously my leg would be short and was actually already 1.5 inches due to previous surgery. (motor bike issues but really me)

I was treated at Liverpool Royal where I had an Illizarov frame fitted and my bone regrown. I will not say it did not hurt but my leg grew about 2.75 - 3 inches so almost the same as before any surgery.

Please have faith in the NHS as they are fantastic and do consult with your NHS consultant if you suffer pain as you will. If you do not tell him/her you are in pain they will not know but if you do then the consultant will be able to prescribe suitable pain killers.

I went through some bad times and only when I mentioned to my consultant he said I should have told him and prescribed a drug which was wonderfull in it killed the pain.

I was so close to losing my leg but now it is approx 3 years later and although I still get pain I can walk for miles (maybe 10 or more) ride a bike (25 or more) and do not limp.

I have nothing but admiration and praise forthe NHS but you as a patient must also input your effort into recovery. I was out of my bed the next day although only 6 or 7 steps then ready to pass out but go for it. I excercise every day to build up and am proof it can be done so if any of you reading this are unfortunate enough to suffer this dreadfull disease then you can beat it.

Best wishes to all and for those that suffer this disease liase with your doctor.

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festering said on 23 April 2010

I have had chronic Osteomyelitis for the past 50 years, i have had four operations on my R/humerus in this time, and have had periods of recession lasting several years, in the early years the flare ups were painful, hence the need for operations to drain the abcesses forming within the bone, in the early years it ment weeks in hospital, with complet bed rest and oral antibiotics, but with modern treatments interavenous antibiotics, my stay in hospital now in no more than a week to two weeks, my last stay was in the Mayday hospital Thornton Heath and i could not fault the care give there, and the inumerable diagnostic procedures carried out to try to establish the cause of the reacurrent flare ups,to date i have not had a flare up for 4 years

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