Bone Inflammation: Causes, Symptoms & Treatment

Osteitis is an infection with often very malignant microorganisms. Open fractures and even surgery are always associated with the risk of osteitis. Radical surgery is usually the only treatment option for bone inflammation.

What is osteitis?

Bone inflammation is a term that, in a narrow sense, refers to a specific infection of the bone. The medical profession refers to it as ostitis or osteitis. Both terms are in parallel use and designate an infection of the compact bone substance and namely:

1. a pathogenic attack of Havers’ canals. These are microscopically small, longitudinally arranged supply lines of the compact bone. Capillaries and nerves run through them. 2. pathogen infestation of the Volkmann channels. These pathways correspond to Havers’ canals and connect them in the transverse direction. Bone inflammation often occurs in combination with osteomyelitis. Because the two syndromes merge, the terms osteitis, osteitis, and osteomyelitis are often used interchangeably. Osteomyelitis thus also refers to bone inflammation in practice.

Causes

Bone inflammation is always the result of infection. Rarely, it is foci of infection in the body that spread to the bone. Mostly, however, the pathogens get into the bone, especially through open fractures, where they trigger the inflammatory event. But even during operations, it is not impossible for germs to be introduced into the bone through non-sterile instruments. Fungi and viruses can be the causative agents of osteitis, but above all bacteria cause the serious inflammation. In addition to streptococci, the bacteria that play a role here are those that occur in connection with nosocomial infections. These are infections that occur in hospitals and nursing homes. Typical here are multi-resistant germs, i.e. microorganisms that no longer respond to several antibiotics. These problematic pathogens include some strains of Staphylococcus aureus, a major cause of bone inflammation as well.

Symptoms, complaints, and signs

Bone inflammation causes severe pain in the area of the bones. The affected areas may be swollen and red, and cysts may also form in the area of inflammation. If the disease is treated early by a specialist, there are usually no further health problems. In the absence of treatment, pus accumulations develop, which can open up to the outside. Occasionally, fistula tracts also develop, through which the secretions penetrate into the tissue. Then severe infections, restricted mobility and a number of other symptoms can occur, always depending on the location of the abscess. In addition, bone inflammation causes typical fever symptoms. Patients are often tired and fatigued, suffer from headache, muscle and joint pain, and notice an increased body temperature. Externally, the disease may be noticed by hot skin and visible swelling, which increases in size as it progresses and eventually opens up. Furthermore, movement restrictions or relieving postures may be noticed. Affected persons often show further symptoms, as bone inflammation is often based on a serious underlying disease such as diabetes or cancer. The signs of the disease appear over the course of days or weeks and subside rapidly with appropriate therapy.

Diagnosis and course

Bone inflammation is manifested by the 5 classic symptoms of inflammation that occur together (heat, redness, swelling, pain, functional limitation). Pus appears at open wounds or fistulas. The physician recognizes a violent inflammatory reaction of the body with strongly increased leukocyte values (white blood cells) on the blood count. An MRI reveals the changes in the bone, where necrotic processes may already be underway. That is, there is death of bone substance. Radical surgery is required, which is risky but unavoidable. Germ infiltration of neighboring organs or the entire body may occur. The chances of recovery vary depending on the severity, but often there is a threat of an unphysiological constellation on the skeletal apparatus. Disabilities are then the result of bone inflammation.

Complications

As a rule, bone inflammation is a very serious disease that must be examined and treated by a doctor in any case.If there is no treatment or direct surgical intervention, irreversible consequential damage may result for the affected person. In most cases, patients suffer from severe bone pain and swelling. The affected regions may also be reddened. The bone inflammation usually also leads to fever and general fatigue and exhaustion. The patient’s ability to cope with stress decreases dramatically. Furthermore, other limbs and joints also hurt. If the bone inflammation is not treated, bone fractures can result. As a rule, these do not heal on their own. Adjacent organs can also be damaged. The quality of life decreases considerably due to the bone inflammation. Bone inflammation is usually treated with antibiotics and other medications. In some cases, surgical intervention is also necessary. In most cases, this does not result in any particular complications.

When should you go to the doctor?

Bone inflammation must be treated immediately. As soon as pain occurs in the bone area, a doctor should be consulted. The physician can clarify the symptoms and choose an appropriate therapy together with the patient. If further symptoms occur, such as increasing malaise, fever or restricted mobility, it is best to consult a doctor on the same day. Patients with chronic bone inflammation must maintain close contact with the physician. The chronic form occurs at intervals and can break out again quite suddenly – in which case the necessary medication should already be to hand. After the disease has subsided, semi-annual check-ups with the doctor are indicated. In this way, any degeneration can be detected and treated at an early stage. If there is a suspicion of a recurrence, the responsible physician must be consulted. The right contact person is the family doctor or an orthopedist. If the symptoms are severe, the affected person should be taken to a hospital or a doctor’s office. With children, the pediatrician should be consulted.

Treatment and therapy

Bone inflammation is usually a bacterial infection and as such requires antibiotics. In most cases, however, oral or IV medication alone is not sufficient to eliminate the focus of inflammation. The surgeon must then excise the affected regions of the bone if they are inflamed or necrotic. If stabilizing elements such as nails and screws were inserted for fracture treatment, they must be removed. Nevertheless, fixation of the fracture site must definitely be taken into account. Often, excision of tissue around the bone is also necessary. Disinfectant irrigation is intended to flush out inflammatory tissue fluids and pathogens as completely as possible. Antibiotic-soaked tamponades or chains remain in the surgical area, and a drain is also placed to drain purulent secretions. Sometimes the surgical wound is not closed, but left open for further treatment. It is possible that only surgery will not produce the desired result, requiring the surgeon to intervene again. Surgery may also be required after healing. This is because the operations have often led to a loss of substance, which must be compensated for as far as possible. The goal is then to restore the patient’s mobility. Otherwise, there is a risk of disability as a result of bone inflammation.

Outlook and prognosis

The prognosis for bone inflammation depends on the time of diagnosis and the accompanying medical history. The severity and extent of the infection determine the prospects for cure, and individual factors such as additional diseases or the patient’s age must also be taken into account. If the bone inflammation is detected at an early stage and treated specifically, complete healing without consequences can be expected in most cases. In advanced cases or if treatment is not sufficiently successful, a chronic form of bone inflammation can develop, which often requires surgical treatment. Complications in the form of abscesses may occur. Fractures can also occur due to the decomposition of the bone tissue. If the infection is particularly severe, bone transplants or amputations may also be considered. Affected patients often suffer from lifelong orthopedic limitations, disabilities and chronic pain.If the infection has spread to neighboring organs, the chances of recovery for the affected patients are again significantly minimized. If an inflammation of the bone is left untreated, the infection can spread unhindered to other bones and organs and cause severe secondary infections. The course of an untreated infection is sometimes fatal. Patients must be increased sensitive to adherence to hygienic measures to avoid re-infection or to prevent worsening of symptoms in the chronic course.

Prevention

Bone inflammation in the context of prophylaxis is predominantly a topic of general hospital hygiene. Here, measures to optimize quality standards can minimize the hazards posed by multidrug-resistant germs. The patient himself can do little. The only thing he or she should do is consult a doctor immediately if he or she suspects that there is a source of infection in the body. This is always advisable, also to the infiltration of the bones can occur and thus also to the bone inflammation.

Aftercare

After acute bone inflammation, scheduled follow-up examinations are usually not necessary. No permanent damage can be expected. However, this does not mean that a disease cannot recur. Surgeries in particular carry an increased risk of this. In contrast, preventive measures to avoid recurrent bone inflammation do not exist. Follow-up care is therefore not necessary in the case of acute bone inflammation. If treatment is started too late or not at all, a chronic form of the disease develops. This is more difficult to treat and requires a number of visits to the doctor. In the worst case, permanent treatment is required for the rest of the patient’s life. Orthopedic limitations and discomfort characterize everyday life. Aids have to be used for simple activities. The disease may even spread to other organs. The physician establishes a regular rhythm for examinations with his patient. A narrow grid is to exclude possible complications. Taking pain-relieving medication is required. Imaging procedures such as X-rays provide a clear indication of the course of the bone inflammation. An ultrasound image clarifies the extent to which soft tissues are affected during follow-up care. Not infrequently, blood samples are also taken. Anamnesis plays an important role in the presentation. Physiotherapy forms an essential part of the therapy.

What you can do yourself

If bone inflammation is suspected, a physician should be consulted first. The medical professional can diagnose the disease and subsequently initiate therapeutic measures – various self-help measures and remedies from the household and nature support the treatment. First of all, the affected limbs should be moved as little as possible and care should be taken to ensure sufficient bed rest and rest. In the case of fever and increased temperature, classic home remedies such as cooling compresses and a gentle diet help. Limb pain is primarily treated with medication, but can also be alleviated by medicinal plants such as arnica or comfrey. If surgery is necessary, the sufferer should have it as early as possible. After the operation, rest and sparing are again indicated. In addition, regular check-ups should be performed, as this is the only way to rule out possible complications and late effects. Since an inflammation of the bone considerably restricts freedom of movement, aids such as a walking aid or wheelchair must also be organized. If no relatives or acquaintances can take over the care, an outpatient nursing service should be called in temporarily. This is particularly necessary in the case of severe inflammation. For minor inflammations, it is usually sufficient to rest the body and especially the affected limbs for a few days.