Osteomyelitis is one of the oldest diseases on record and as of 2010 affects two out of every 10,000 people, according to Joint-Pain-Forum.com. Osteomyelitis was very hard to control and treat until the development of antibiotics. The discovery of penicillin in 1928 paved the way for effective treatment against osteomyelitis starting in the late 1940s. With the advances in personal hygiene, standards of living and disease understanding, osteomyelitis is a manageable disease with a good outcome if caught early.
What is Osteomyelitis?
Osteomyelitis is an acute and chronic bone infection caused by bacteria or fungi. There are multiple ways in which a bone may become infected, but once infected the body's immune system response is the primary cause of the symptoms associated with osteomyelitis. Chemicals released by immune cells and blood flow impairment lead to the destruction of bone tissue and the symptoms associated with the disease.
Symptoms
Common symptoms of osteomyelitis include localized bone pain and swelling or redness. Malaise, fever and nausea are also common problems encountered in individuals with osteomyelitis. Less common symptoms include chills, excessive sweating, low back pain and swelling of the ankles, feet and legs. In children, the disease most often affects the long bones of the body, and in adults the bones of the feet, vertebrae and hips.
Causes
Infection of the bone by certain bacteria or fungi causes osteomyelitis, with the most common cause being an infection by staphylococcus aureus. Several risk factors put individuals at an increased risk of developing osteomyelitis. These include hemodialysis, diabetes, IV drug abuse and individuals with weakened immune systems or sickle cell disease. Certain situations increase the chance of an infection, such as an injury in which the bone pierces through the skin, chronic open wounds and individuals with pneumonia or urinary tract infections.
Diagnosis
A complete medical history and physical examination are the first steps in diagnosing osteomyelitis. Once osteomyelitis is suspected, a physician will run several blood tests such as a complete blood count (CBC) or blood culture to determine if an infection is present. Sometimes, a biopsy or needle aspiration of the bone is necessary. Bone scans or x-rays can help in viewing the affected bones or extent of damage.
Treatment
The outcome of acute osteomyelitis is good, but worse if the condition goes undetected and becomes chronic. The first goal is to eliminate the infection and prevent chronic osteomyelitis with the use of antibiotics, generally for six to eight weeks. Depending on the severity of the disease, immobilization may be needed to avoid further trauma or injury to the infection site. Often, dead and destroyed bone tissue is removed with surgery, especially with more established infections.
