Osteomyelitis

Diagnosis

Your healthcare professional may examine the affected area for tenderness, swelling, or warmth. If there is a sore on your foot, they might use a blunt probe to determine how deep it is and whether it reaches the bone.

To confirm osteomyelitis and identify the germ responsible for the infection, several tests may be performed, including blood tests, imaging tests, and a bone biopsy.

Blood tests can show higher levels of white blood cells and other infection markers, helping to indicate that your body is fighting an infection. Although blood tests cannot confirm osteomyelitis directly, they can guide your healthcare provider in deciding what further tests are necessary.

Imaging tests may include:

• X-rays, which can show bone damage but may not reveal early infections.

• MRI scans, which use radio waves and magnetic fields to create detailed images of bones and surrounding tissues.

• CT scans, which combine multiple X-rays from different angles for a detailed internal view, often used when MRI isn’t possible.

• Bone scans, which use a small amount of radioactive tracer absorbed by infected bone tissue to highlight areas of infection.

A bone biopsy is the most definitive test for osteomyelitis, showing exactly which germ has caused the infection. This helps your healthcare professional choose the most effective antibiotic.

• In an open biopsy, surgery is performed under general anesthesia to remove a bone sample.

• In a needle biopsy, a long needle is inserted through the skin into the bone under local anesthesia, guided by imaging such as X-ray or CT.

Treatment

Treatment for osteomyelitis usually combines surgery to remove infected or dead bone with antibiotics given through a vein.

Surgical treatment may include:

• Draining the infected area to remove pus or fluid buildup.

• Removing diseased bone and surrounding tissue in a procedure called debridement to eliminate all traces of infection.

• Restoring blood flow by filling the space left after debridement with a bone or tissue graft, such as muscle or skin from another part of the body.

• Removing foreign materials, such as plates or screws from previous surgeries, if they contribute to the infection.

Medication plays a key role in recovery. Antibiotics are selected based on the identified germ and are usually given intravenously for about six weeks. In severe cases, oral antibiotics may follow.

Lifestyle adjustments also support healing. Quitting smoking can speed up recovery, and managing long-term health conditions such as diabetes is essential for better outcomes.