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Am Fam Physician. 2011;84(9):1034

See related article on osteomyelitis.

What is osteomyelitis?

Osteomyelitis (OSS-tee-oh-MY-uh-LIE-tiss) is an infection in a bone. It is caused by bacteria that spread through the blood from a wound or infection somewhere else in the body. In children, it usually occurs in the arms and legs. In adults, it usually affects the feet, spine, or hips. People with diabetes or poor circulation are more likely to get osteomyelitis.

What are the symptoms?

Children usually have pain, swelling, and redness over the area that is infected. They also may have a fever or trouble moving the arm or leg, and they may be more tired than usual. In adults, the symptoms can be harder to pinpoint. They may have a fever or feel tired. There may be pain in the area over the bone, and wounds may take longer to heal. Symptoms can take up to six weeks to develop after the infection has started.

How is it diagnosed?

In children, osteomyelitis is usually diagnosed by the symptoms and a physical examination. In adults, the diagnosis can be more difficult because the symptoms and examination are not always clear. Blood tests can show an infection in the body, but other tests, such as x-rays or magnetic resonance imaging (MRI), must also be done. The best way to tell if a patient has osteomyelitis is to remove a piece of damaged bone and test it for bacteria.

How is it treated?

The main treatment for children and adults is antibiotics. Antibiotics are usually given first through an IV to get high doses of the medicine into the blood. Later on, antibiotic pills may be used. Children usually need about four weeks of antibiotics. Adults need to take antibiotics for six to eight weeks. Sometimes surgery is needed to clean out the infected bone.

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