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Osteomyelitis is an infection of the bone. In order for the bone to become infected, a pathogenic or infection producing organism must gain access to the involved site. There are two basic types of osteomyelitis; acute and chronic. Acute osteomyelitis is one in which there is an "active" infection. The skin surrounding the wound is usually red, warm, swollen, and frequently has a foul smelling discharge from the wound site. Chronic osteomyelitis is just how it sounds; "a chronic or long-standing infection". The difference between acute and chronic osteomyelitis is that the acute form shows the traditional clinical signs of infection where the chronic form usually does not. Chronic osteomyelitis frequently involves exposed bone. However, the redness, heat, swelling, and malodorous drainage is usually not present.
Osteomyelitis can be caused by a number of factors. An aggressive infection that breaks through the skin and penetrates the bone is usually the way it works. A simple opening in the skin from an ulcer, trauma, or surgery can cause this condition. If the infection is not quickly treated, an osteomyelitis may form. Diabetics are often prone to developing this type of bone infection. The reason is that many diabetics do not have adequate feeling on the bottom of their feet and will develop ulcers without being aware of the problem. The infection then progresses and is often not treated in time to prevent a bone infection. If you have an "opening" or localized wound site on your foot that seems to be slow or non-healing, a foot specialist should be consulted.
Osteomyelitis can be treated either conservatively or aggressively depending on the severity of the condition. Conservative treatment would consist of intravenous antibiotics without removing bone. This treatment is frequently utilized initially until lab studies identify the actual organism causing the infection. A more specific medication may be used in an IV fashion to more effectively treat the infection while further studies are done to evaluate the extent of bone involvement. Once this information is available via bone biopsy, bone scan, MRI or x-rays, the offending bone should be removed as well as using IV antibiotics.