If your kids are like most, they're probably pretty active and not always as careful as they should be. Minor scrapes and bruises that develop on their arms and legs will usually heal on their own — but deeper wounds that are left untreated can become infected, and lead to a bone infection. In medical terms, that's called osteomyelitis.
Osteomyelitis is most commonly caused by the bacterium Staphylococcus aureus, but other bacteria can cause it, too. Germs usually enter the body's tissues through an open wound (often a broken bone that breaks the skin), but can also travel to a bone through the bloodstream from another infected area in the body (this is called hematogenous osteomyelitis).
A bone also can become infected when the blood supply to that area is disrupted, such as in older people with atherosclerosis (a narrowing of the blood vessels) or in those with diabetes. Atherosclerosis or diabetes-related bone infections usually occur in the toes or other bones in the feet. Osteomyelitis from other causes usually affects the long bones of the arms and legs.
Signs and Symptoms
Kids with osteomyelitis often feel severe pain in the infected bone, and might have fever and chills, feel tired or nauseated, or have a general feeling of not being well. The skin above the infected bone may be sore, red, and swollen.
It's often difficult to diagnose osteomyelitis in infants and young children because they don't always show pain or feel specific symptoms in the area of the infection. Additionally, older people with atherosclerosis or diabetes sometimes lose the ability to feel pain (called neuropathy), so their symptoms also might not be evident. In teens, who tend to develop osteomyelitis after an accident or injury, the injured area may begin to hurt again after initially seeming to get better.
Diagnosis
If your child has a fever and bone pain, visit the doctor right away. Waiting is not recommended because osteomyelitis can get worse within hours or days and become much more difficult to treat.
The doctor will perform a physical exam and ask questions about recent injuries to the area that's painful. Blood tests might be done to see whether the white blood cell count is elevated (a sign of infection) and to look for signs of possible inflammation or infection in the body. An X-ray may be ordered; however, X-rays usually don't show signs of infection in someone who has had osteomyelitis for a little while.
If osteomyelitis is suspected, the doctor might suggest a bone scan, which provides a more detailed look at the bone. The doctor might also recommend an MRI (magnetic resonance imaging), which produces much more detailed images than X-rays. MRIs not only can diagnose osteomyelitis, but can help establish how long the bone has been infected.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.