Monday, February 17, 2014

Osteomyelitis


Since it has been awhile since I have posted on this blog, I wanted to post on a topic that I have seen a lot of patients develop recently.  I decided to talk a little bit about osteomyelitis, or bacterial infection of bone.

Working at the wound care center, I have found that a great deal of patients with chronic ulcerations can develop infection in the bone under the ulcer.  I have also found that a doctor needs to suspect this whenever there is a chronic wound that is not healing.  To say it in simple terms, infected bone can "die" and needs to leave the body and this can often be why a wound will not heal.  If infected bone can not find a way to "exit" the body, this infection can lead to a localized infection or abscess.

Sometimes a simple x-ray is enough to suspect osteomyelitis but often more advanced studies such as a bone scan or MRI are necessary to form a diagnosis.  The only definitive test, however, is a biopsy of the bone.  In my experience, though, MRI / bone scan is pretty reliable and a bone biopsy is often deferred due to its invasive nature.

Treatment for osteomyelitis includes more than 6 weeks of IV antibiotics and / or resection of the infected bone (amputation).  Obviously, amputation is always a last resort.  Medicine has made great advances to treat osteomyelitis.  Hyperbaric oxygen therapy is one such treatment.  The clinician must also assess other issues such as a patient's circulation to heal the infected bone and the patient's nutrition.

If you have a chronic wound that will not heal, do not delay treatment.  See you podiatrist if it is a foot or ankle wound or wound care specialist for any chronic wounds.

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