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Bone & Joint Infection

Bone and joint infections can be very destructive because the disease causing microorganisms–bacteria, viruses and parasites can damage healthy tissues, multiply increasing in their number and also spread through the blood stream. Sometimes, even a skin or other soft tissue infection can lead to bone infection or osteomyelitis. Thus, never neglect even a small cut on your finger or toe as it could get worse and cause severe disability. These infections need immediate treatment without which they tend to be chronic. Early diagnosis, appropriate antibiotic treatment and surgical intervention if necessary can treat most of the infections and prevent further problems.

You will be at a higher risk of these infections if you are suffering from chronic diseases such as rheumatoid arthritis, diabetes mellitus, haemophilia, sickle cell anaemia and human immunodeficiency virus- acquired immuno-deficiency syndrome (HIV-AIDS). Infection may develop through a breach in your skin particularly puncture wound caused by a contaminated sharp object.

Bone infection is called osteomyelitis and is mainly caused by a bacterium (staphylococcus aureus). It occurs as a result of open fracture with the ends of bone piercing the skin, or by spread of infection from other parts of the body (pneumonia or a urinary tract infection), or a secondary bone infection in a chronic open wound. If osteomyelitis is left untreated, infection becomes chronic and blood supply to affected bone is lost leading to gradual bone death.

When there is an infection, the affected area will appear red, be warm and inflamed. There may be pain, stiffness, reduced range of motion and pus drainage accompanied by fever and chills. If you suspect an infection, consult your doctor right away as early treatment prevents complications. Your doctor will perform physical examination and order diagnostic tests such as X-rays, MRI scans to check for the extent of bone and soft tissue damage. Further, blood tests may be done to identify the causative microorganism.

Treatment

Treatment for osteomyelitis includes the following:

  • Drainage: If an abscess has formed, pus will be drained through needle aspiration procedure in which the fluid is withdrawn through the needle inserted into the affected area
  • Medications: Appropriate antibiotics will be prescribed to get rid of the infecting bacteria from the bloodstream. They may be given directly into the vein or through oral formulations
  • Splinting and cast immobilisation: The affected bone may be immobilised to help in healing and avoid further trauma
  • Surgery: In severe conditions, bone infections are managed through open surgical procedure in which the necrosed bone and tissues are debrided away

    Joint infections such as septic arthritis are also treated similarly with antibiotic medications and prompt surgical drainage. Repeated joint aspirations may be done
Prof Minoo Patel,MBBS, MS, FRACS, PhD - Centre for Limb Lengthening & Reconstruction Prof Minoo Patel,MBBS, MS, FRACS, PhD - Centre for Limb Lengthening & Reconstruction
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