2 Sep 2011
Osteomyelitis is infection in the bone. Osteomyelitis can occur in infants, children, and adults. Different types of bacteria typically affect the different age groups. In children, osteomyelitis most commonly occurs at the ends of the long bones of the arms and legs, affecting the hips, knees, shoulders, and wrists. In adults, it is more common in the bones of the spine (vertebrae) or in the pelvis. There are several different ways to develop osteomyelitis. The first is for bacteria to travel through the bloodstream (bacteremia) and spread to the bone, causing an infection. This most often occurs when the patient has an infection elsewhere in the body, such as pneumonia or a urinary tract infection, that spreads through the blood to the bone. An open wound over a bone can lead to osteomyelitis. An open fracture where the bone punctures through the skin is also a potential cause.
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A recent surgery or injection around a bone can also expose the bone to bacteria and lead to osteomyelitis. Patients with conditions or taking medications that weaken their immune system are at a higher risk of developing osteomyelitis. These include patients with cancer, chronic steroid use, sickle cell disease, human immunodeficiency virus (HIV), diabetes, hemodialysis, intravenous drug users, and the elderly. Symptoms of osteomyelitis can vary greatly. In children, osteomyelitis most often occurs more quickly. They develop pain or tenderness over the affected bone, and they may have difficulty or inability to use the affected limb or to bear weight or walk due to severe pain. In adults, the symptoms often develop more gradually. Other symptoms include fever, chills, irritability, swelling or redness over the affected bone, stiffness, and nausea. The diagnosis of osteomyelitis begins with a complete medical history and physical examination. During the medical history, the doctor may ask questions about recent infections elsewhere in the body, past medical history, medication usage, and family medical history. The physical examination will look for areas of tenderness, redness, swelling, decreased or painful range of motion, and open sores. Your doctor may then order various tests to help diagnose osteomyelitis. Several blood tests can be used to help determine if you have an infection in your body. These include a complete blood count (CBC), the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and blood cultures. None of these is specific for osteomyelitis but rather they can suggest that there may be some infection in the body. Imaging studies may be obtained of the involved bones. These can include plain radiographs (X-rays), bone scans, computed tomography (CT) scans, magnetic resonance imaging (MRIs), and ultrasounds. These imaging studies can help identify changes in the bones that occur with osteomyelitis. After an area of bone is identified with possible osteomyelitis, a biopsy of the bone may be obtained to help determine precisely which bacteria are involved, and the culture of this can indicate the best choice for antibiotic treatment. In many cases, osteomyelitis can be effectively treated with antibiotics and pain medications. If a biopsy is obtained, this can help guide the choice of the best antibiotic. In some cases, the affected area will be immobilized with a brace to reduce the pain and speed the treatment. Sometimes, surgery may be necessary. If there is an area of localized bacteria (abscess), this may need to be opened, washed out, and drained. If there is damaged soft tissue or bone, this may need to be removed. If bone needs to be removed, it may need to be replaced with bone graft or stabilized during surgery With early diagnosis and appropriate treatment, the prognosis for osteomyelitis is good. If there is a long delay in diagnosis or treatment, there can be severe damage to the bone or surrounding soft tissues that can lead to permanent deficits. Commonly, patients can make a full recovery without longstanding complications. I hope all the best for your mother and that she is able to be put on a good antibiotic and responds quickly. Osteomyelitis is notorious for being difficult to get rid of but some people respond very quickly so it can depend on whether or not the infection is one of the more ressistant forms of bacteria like MRSA (methicillin-resistant Staphylococcus aureus). These can be difficult to treat because as the name suggests the bateria is very resistant to many antibiotics so be patient if this is the case. It may take more than one antibiotic or more than one course of antibiotics. Sorry this post is so long but I wanted to provide you with some information because it doesnt sound as if you have been getting any. All the best to you both and I will be praying for her swift recovery! :) Dzoo.