Pacific Rim Orthopedic Surgeons


What is Osteomyelitis?

Osteomyelitis is a painful bone infection that causes swelling, which can damage the bone and encourage bone loss. The infection is caused by bacteria and fungi but can be successfully treated with antibiotics, though surgery may be recommended as well. The groups of people most at risk for developing osteomyelitis include younger children, elderly adults, and people with diabetes.

A person holding their foot near their toe joint in pain.

Types of Osteomyelitis

Osteomyelitis causes painful swelling of the bone marrow, which is the soft and spongy tissue inside the bones. If the bone infection isn’t treated, the swelling can cut off the blood supply to the bone and lead it to die. It is one of the oldest diseases known and affects 2 out of 5 people.

While the infection can affect people of all ages and genders, children younger than three years old, people with a serious medical condition, and elderly adults are more at risk for developing osteomyelitis.

There are three types of osteomyelitis:

Type 1: Acute osteomyelitis

When the infection comes on suddenly, developing a fever with pain in the infected area within days after.

Type 2: Chronic osteomyelitis

The bone infection doesn’t go away with treatment, causing bone pain and recurring pus. While the infection may go undetected for months or years, it is rarely without symptoms.

Type 3: Vertebral

This type of osteomyelitis affects the spine and causes chronic back pain that worsens with movement. The usual back pain treatments such as heating pads and pain relievers don’t help, but this type of osteomyelitis rarely causes fever and is more common among IV drug users and people on dialysis.

Causes & Symptoms of Osteomyelitis

Osteomyelitis is caused by nearby infected tissue or an open wound that has circulated bacteria and settled into the bone, where it multiplies. Often a staph infection leads to osteomyelitis, but fungus or other germs can cause it as well. There are risk factors that increase the likelihood of developing osteomyelitis, such as:

  • having an artificial joint
  • having a blood infection or conditions like sickle cell anemia
  • having diabetes, especially a related foot ulcer
  • metal implants in bones
  • bedsores
  • a recent broken bone or bone surgery
  • a traumatic injury or wound
  • a weakened immune system

Osteomyelitis symptoms can vary depending on the type and cause, such as those with chronic osteomyelitis typically not showing any symptoms. Other signs include:

  • pain in the affected area
  • Red, warmth, and swelling in the affected area, often tender to the touch
  • Yellow pus drainage
  • fever
  • irritability of lethargy
  • loss of appetite
  • lower back pain
  • limited and painful range of motion
  • nausea and vomiting
  • sweating and/or chills

Osteomyelitis Treatment & Diagnosis

To properly diagnose osteomyelitis, your doctor will assess your symptoms and perform a physical exam, as well as order one or more of the following tests:

  • Blood test: a complete blood count to check for signs of inflammation and infection, and a blood culture to look for bacteria in the bloodstream.
  • Imaging tests: X-rays, MRIs, CT scans, and ultrasounds to see the bones, muscles, and tissue
  • Bone scan: using a small amount of safe radioactive material, the doctor can identify infections or fractures during an imaging scan
  • Biopsy: your doctor may perform a needle biopsy to take samples of fluid, tissue, or bone to look for signs of infection.

There are several osteomyelitis treatment options, though the bone infection can take considerable time to heal, it is faster if treatment is started within three to five days of noticing symptoms:

  • Antibiotics: typically administered for four to eight weeks, beginning with IV in the hospital for a week or two and followed by oral medications for several more weeks.
  • Antifungals: if the osteomyelitis was caused by a fungus, oral antifungal medication will need to be taken for several months
  • Needle aspiration: to drain the pus and fluid from the abscess
  • Pain relievers: to help treat the pain and inflammation
  • Bone surgery: to surgically remove the infected and dead tissue and bone
  • Spine surgery: for those with vertebral osteomyelitis, the procedure helps prevent the vertebra from collapsing and damaging the spinal cord, nerves, and other parts of the nervous system.

Make an Appointment with our Musculoskeletal Trauma Specialists

If you’ve suffered any of the symptoms listed above, we encourage you to make an appointment!

We at Proliance Pacific Rim Orthopedic Surgeons strive to help our patients achieve a return to normal activity through compassionate and exceptional care using evidence-based medicine in a patient-friendly environment. We are committed to bringing you a high standard of care that is patient-focused, with the goal of improving your quality of life.