Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 30, 2016

Osteomyelitis is a bone disease that involves an infection in the bones. The infection usually begins in the bloodstream or in tissue near the bone, and when left untreated, can spread to infect the bones themselves. Osteomyelitis is most often located in the arm or leg bones, or in the bones of the spine. To remove dead, infected bone tissue, surgery is almost always necessary.


Definition & Facts

Osteomyelitis is an extremely rare bone infection caused by the traveling of an infection from the bloodstream or neighboring tissue. In most cases, the infection is caused by bacteria but it can also be caused by fungi or other pathogens.

Osteomyelitis can appear in both children and adults, but the location of infected bones usually differs depending on the patient's age. In children, a bone infection is most likely to appear in the long bones in the legs or arms, but adults are more likely to see the infection in the vertebrae and bones of the spine. Osteomyelitis can also occur in the foot bones, particularly for individuals who suffer from diabetes.

Symptoms & Complaints

The most common symptom and complaint associated with osteomyelitis is pain in the infected bones or swelling of the infected limb. The infected limb may also become red and radiate heat. Osteomyelitis can cause pain in the area surrounding the infection.

The bone infection can also cause other symptoms such as excessive sweating, fever and chills, or just general discomfort and uneasiness. Depending on the location of the osteomyelitis, the individual may also experience swelling in the ankles, feet, or legs.

If a child has osteomyelitis, he or she may experience irritability or lethargy. It is also important to note that osteomyelitis does not always show symptoms or may show fewer symptoms than what is considered typical.


Osteomyelitis occurs when the infection from another area of the body reaches the bones. Under most circumstances, the infection is caused by staphylococcus bacteria, which is frequently found on the skin or in the mucous membrane. Although those forms of bacteria are commonly found on the outside of our skin and bodies, once they enter the body, they can cause infection and pain.

The bacteria usually enters the body in one of three ways: through the bloodstream, through an open wound, or through infected tissue or a prosthetic joint infection. If the bacteria enters the body and is left untreated, it can spread into the bones and cause osteomyelitis. For children, the bacteria most commonly occurs in areas known as growth plates, which are still soft and therefore more prone to infection.

There are a number of risk factors when it comes to osteomyelitis, including having had a recent injury or surgery, having a disorder of the circulatory system, having problems with catheters, a condition that affects your immune system, or drug abuse.

Diagnosis & Tests

In most cases, a combination of tests will need to be done in order to determine if a bone infection is present. The first of those tests usually involves blood tests. While a blood test can not fully determine if you have osteomyelitis or not, it can determine if your body is fighting an infection. If there is an increased amount of white blood cells, it may be an indication to your doctor that additional tests need to be performed.

The second round of tests usually involves taking images of the bones, including X-rays, CT scans, or MRIs. Through the images created in these tests, the doctor can determine if there is damage to the bone. It may take a few weeks of damage to occur before it can appear in these images. Finally, a doctor may do a biopsy to diagnose osteomyelitis. This can also determine what germ or bacteria is present and causing the infection.

Treatment & Therapy

From the bone biopsy, the doctor will be able to determine which form of bacteria or germ is causing the infection. They can then prescribe antibiotics to fight the infection, which will usually need to be administered directly into the veins for a few weeks.

Surgery is almost always necessary, although the level of surgery needed will depend on how far the infection has spread. Basic surgery may only need to drain the pus in the area of infection. It may also require that the doctor remove the infected section of bone and tissue. In the most extreme cases of osteomyelitis, the doctor may feel the only way to stop the infection from spreading further is to amputate the entire limb.

Prevention & Prophylaxis

Although osteomyelitis is an extremely rare condition, it is still necessary to take all the precautions possible when potentially facing an infection. If you have a disease involving an infection of your lungs or other area of your body, take extra precautions to eliminate the infection before it can spread.

If you are undergoing surgeries, discuss with your doctor the best ways to reduce your chance of infection and what you can do to keep your surgical incision free of bacteria and germs. You should also avoid cuts or scrapes as best you can, but in the event that you do have an open wound, be sure to clean it properly and consistently and leave it covered with a clean bandage. This is particularly important when dealing with children who are more prone to cutting or scraping their limbs.

It is also important to frequently check the areas of cuts and scrapes for any signs of infection in the area. If you do have an infection in some area of your body, take all of the necessary precautions and steps you can take to ensure that the infection does not spread.