Overview

Osteomyelitis is a painful bone infection. It usually goes away if treated early with antibiotics. It can cause serious long-term problems if it's not treated.

Who's at risk of getting osteomyelitis

Anyone can develop osteomyelitis, but you're more at risk of getting it if you have:

• had osteomyelitis before
• diabetes, especially if you also have a foot ulcer
• broken (fractured) a bone
• been injured and have a wound
• had an infection
• had surgery
• a weakened immune system (for example, because of chemotherapy, or you have a condition such as HIV)

Children may also be more likely to get osteomyelitis after having a respiratory infection or chickenpox.

Symptoms of osteomyelitis

Osteomyelitis usually causes severe pain, most often affecting the legs, but it may affect other parts of the body.

Other symptoms of osteomyelitis can include:

• swelling of the affected area
• a feeling of warmth on the affected area
• redness of the skin in the affected area, which may be harder to see on black or brown skin
• a limp (more common in children)
• a high temperature

Ask for an urgent GP appointment or contact NHS 111 if you have:

• pain, swelling, redness and a warm sensation over an area of bone
• a very high temperature (or you feel hot and shivery) and feel generally unwell
• had osteomyelitis before and you think the symptoms have come back
• Take your child to a GP if:
• they do not want to use an arm or leg and seem irritable - young children do not always get a high temperature with osteomyelitis

You can call NHS 111 or get help from NHS 111 Wales online.

If it's not treated quickly, osteomyelitis can cause serious long-term problems, such as infections and permanent damage to your bones.

What happens at your GP appointment

The GP will examine the area and may do some tests to find out if you have a bone infection.

You might need a blood test, or to go to hospital for:

• an X-ray, CT scan or MRI scan
• a biopsy, where a small sample of fluid is taken from the bone and sent for testing

Treatment for osteomyelitis

Osteomyelitis is treated with antibiotics. You may need treatment in hospital, or you might be able to take antibiotics at home.

You'll usually take antibiotics for 4 to 6 weeks. If you have a severe infection, you may need to take them for up to 12 weeks. It's important to finish a course of antibiotics even if you start to feel better.

If the infection is treated quickly (within 3 to 5 days of it starting), it often clears up completely.

You can take painkillers to ease the pain. If the infection is in a long bone (such as an arm or leg), you may be fitted with a splint so you do not move it as often.

Surgery for osteomyelitis

You'll usually need an operation if:

• a build-up of pus (abscess) develops in the bone and the pus needs to be drained
• the infection presses against something else, for example, the spinal cord
• the infection has lasted a long time and damaged the bone

If the infection has damaged the bone, you'll need surgery (known as debridement) to remove the damaged part.

Debridement can leave an empty space in the bone, which may need to be reconstructed.

Sometimes more than 1 operation is needed to treat the infection. Muscle and skin from another part of the body might be used to repair the area near the affected bone.

Diabetes and osteomyelitis

It's very important to look after your feet if you have diabetes.

If you have poorly controlled diabetes, you can lose sensation in your feet and not notice small cuts, which could develop into an infection that spreads to the bone.