What is Osteomyelitis?

Osteomyelitis is an infection in the bone caused by bacteria entering the bone. The bacteria may come from a minor skin infection, a cold or a puncture wound.  However, it is often difficult to know the exact cause. Most commonly, the bones around the knee, hip or ankle are affected.

Children who have osteomyelitis will normally present with symptoms including:

• Feeling unwell and a fever- with a temperature over 38° C 
• Swelling, redness, warmth and pain in the affected area
• Reluctance to move the affected area or limb
• Limp or refusal to weight bear through the affected limb

Who gets it?

Osteomyelitis is more common in boys than girls (2.5:1) and most commonly occurs in children under 10 years of age. It occurs in 1 in 5000 children under the age of 13 years. It is not uncommon to occur in healthy children.

What is the natural History of Osteomyelitis?

Osteomyelitis is a condition that usually requires specialist care in a hospital. With early diagnosis and specialist treatment the outcomes are very good and most cases will not result with any long term damage to the bone. However, careful follow up with an orthopaedic doctor is required.

What is the treatment?

If you think your child has osteomyelitis you should take them to your GP for assessment.

Most children who have osteomyelitis will need be admitted to hospital for specialist treatment. This will involve:

• Antibiotics (intravenously)
• Pain relief medicine
• Surgery is rarely required but may be indicated if antibiotics do not successfully treat the infection.

While in hospital, children with osteomyelitis will need to have their temperature monitored closely as well as regular blood tests to monitor their progress and recovery.

They will need to continue to take antibiotic medicine throughout this process and may need to continue to have antibiotics once they leave hospital and are at home. If IV antibiotics are required at home, a nurse will visit the home to assist with this. It may also be necessary to take oral antibiotics – (liquid or tablets) for another three to six weeks.

Children can usually be discharged from hospital once their temperature has remained normal for 24 hours. Recovery time and hospital stay for each child will vary.

What tests are required?

A range of tests are often required. These may include a blood test, x-ray, MRI, CT scan and bone scan.

What follow up is required?

Regular follow ups are required, even once a child seems well. These appointments are important and necessary to check that the affected bone continues to grow and develop. Blood tests may be required in preparation for these follow up appointments.