Osteoarthritis is an infection of the bone and or bone marrow. The infection may be due to a bacteria, virus, fungus, or a parasite.
Symptoms of osteomyelitis can be varied including pain, swelling, redness, cellulitis, fevers, chills, nausea. Osteomyelitis may also have no associated symptoms especially if in a chronic stage. If osteomyelitis involves the growth plate there may be a disruption of growth for the particular bone involved.
Causes of osteomyelitis as mentioned can be either from a bacterial, viral, fungal, or parasitic infection. This can occur through two different mechanisms. One way is through the bloodstream from a distant source through whats termed a hematogenous spread. A good example is if a patient had an abcess in their tooth with mild infection or from a urinary tract infection. The bacteria can be picked up in the blood stream and travel to a specific site of bone. The bone then becomes infected and walls off an abcess of its own. Although this is a common type of osteomyelitis in the body, it is less common with types involving the bones of the foot.
The second way to get osteomyelitis is from a direct spread from external sources, which is more common with the foot. Patients with diabetes may form an ulceration in the skin allowing for a direct spread of infection. This can occur with any type of break in the skin.
Any time the bodies immune system is compromised there is a greater chance for osteomyelitis. In addition, if the blood flow is decreased treatment is more difficult as the body doesn't have a good transport system to kill the causative organisms.
Diagnosis is first by clinical suspicion of symptoms. A thorough examination by your podiatrist should be made when first suspected of any type of foot infection. X-rays are usually taken to see the extent of osteomyelitis and comparison x-rays will be taken to see the progression of the disease. A bone scan is sometimes used to aid the doctor in his diagnosis. Bone scans are not always indicated if the osteomyelitis is evident on plain x-rays. The most definitive way to diagnose a bone infection is by performing a surgical biopsy of the bone. Every individual may be treated differently depending on the age, health, location of the involved bone, and extent of the infection. Blood test are commonly used to help manage the disease.
Treatment is greatly varied. The actual infected bone as well as the source of its infection needs to be identified and treated. Some patients may be treated as an outpatient and monitored on a regular basis. Others may need admitted as an inpatient to a hospital for testing, monitoring, and treatment. Antibiotics is a usual step taken and they may be switched during the course, depending on what organisms are typical and what other tests indicate. Some antibiotics can be taken by mouth, others need to be given intravenously (IV). Surgery is common with patients having osteomyelitis as dead or necrotic bone can lead to further spreading of the infection to a greater extent and become limb and/or life threatening. It's possible your podiatrist may suggest an amputation of part of a toe, foot, or limb for the best treatment in these situations.