How to Spot Osteomyelitis [Infographic]
Osteomyelitis is one of those rare diagnoses that may seem insignificant…until you find yourself caring for a patient affected by it.
Here are some quick things to know about osteomyelitis so you can catch and treat it early!
What is Osteomyelitis?
As you can guess from the name, osteomyelitis is an infection in the bone.
The infection can be caused by:
- bacteria
- fungi
- parasites
- viruses
These invaders usually enter through an open wound or travel from somewhere else in the body via the bloodstream.
Once the pathogen reaches the bone, the infection causes major inflammation. Eventually, this inflammation can result in necrosis (tissue death). The infection can also travel along the bone and cause major damage to surrounding tissue.
Unfortunately, if it’s not treated quickly and aggressively, patients risk permanent loss of bone and the affected tissue.
How rare is it?
The Cleveland Clinic states that about 2 people in 10,000 have osteomyelitis.
It’s definitely not the most common issue. But, knowing what to look for and what tests to recommend could save the limb (or even life!) of that rare patient that you may come across.
Working as a wound care nurse, I’ve come across osteomyelitis in several of my patients. It’s especially common in wounds over areas of “thin” skin. For example, heel and toe wounds where bone is already very close to the skin’s surface.
What are the symptoms of osteomyelitis?
It can be especially tricky to zero-in on the diagnosis. Since a lot of the signs are related to inflammation, they can appear to point to an infection anywhere in the body.
If you notice any of these general signs, your patient may have an infection brewing somewhere:
- Pain
- Fever
- Malaise
Some of the more specific warning signs that should make you consider osteomyelitis:
- Localized pain or redness
- Slow or non-healing wounds
- Chronic wound that re-opens after healing
How is osteomyelitis diagnosed?
Common tests you might see ordered (or may want to request) are:
- WBC – to check for elevated white blood cell count
- x-ray – to visualize any bone damage
- bone scan – to check for increased cellular activity (which points to infection)
- culture & sensitivity – to identify infecting organism and direct treatment
- bone biopsy
How is it treated?
The treatment choice usually depends on how much damage has already been done. The major priority is removing any necrotic bone and pus. In addition, antibiotic medication is usually initiated for approximately 4-6 weeks if IV or 6-8 weeks for oral treatment.
Osteomyelitis patients need pain monitoring and pain medication. And, in extreme cases when there is gangrenous tissue or poor blood flow, amputation may even be necessary.
It’s essential for nurses to keep monitoring patients closely throughout the treatment process. It’s also important to keep an eye out for this word in your admissions and histories.
If acute osteomyelitis is not totally eliminated, the infection can become chronic and put patients at higher risk for lifelong complications.
The good news is, when osteomyelitis is caught and treated early, patients can usually recover fully.
Have you ever come face-to-face with osteomyelitis? Let me know in the comments!
And don’t forget to check out the infographic below for the fast-facts.
In 2002 I had an accident with a forklift truck. Went to the hospital, had an X-Ray, and was told I had a badly sprained ankle. Two years later I went to a Radiology Clinic. It was found that I had a small dice-shaped piece of fat/bone that moved across the front of my ankle and was causing me all the pain. Had a daily OP to have it removed. Unfortunately, the after-treatment was not the best. To cut the story short, I ended up ten (10) weeks in the hospital with the first three in quarantine. I was told that I had three options. 1: Amputation of the ankle. 2: Another OP to open up the ankle and scrape the bacteria out, but the chance that the bone skin would be disturbed or destroyed would most likely happen. and 3: I was to lay in bed with the leg stuck up in the air and hope that the Bacteria would be removed through normal body functions. I was also told that as I had Chronic Osteomyelitis I had approximately 12 years to live. 20 years later I still have my pain and take Tilidin Retard tablets every day. After X-Rays over this period showed that the bacteria is now all over my body in the bone marrow. Life goes on slowly.
What is the best option for chronic osteomyelitis that is at the femur ( thigh bone)
Hello again, to bring my last reply up to date. My Chronic Osteomyelitis is still with me. One learns to push the problem and pain to the back of your head. That may sound a bit stupid to some people. But having lived with this problem for over 22 years you learn to live with it. I wear Orthopedic shoes/boots. They hold my foot/angle safe and sound. The shoe/boot is constructed to hold my foot and leg in an “L” shape form without any movement. The shoe/boot has metal inside, so my leg and foot stay as needed. This problem is with my left leg, so I can get about in a car, meaning I need only my right foot for the acceleration and braking. Walking long distances is a problem so I have to plan my days or journeys. Still taking pain-killing tablets but now have “Tilidin”100mg/8mg Retardtablets. I have learned to live with my problem and get on with my life.