Signs and Symptoms - Pain in a specific bone with overlying redness - Fever - Weakness - Inability to walk, especially in children with acute bacterial osteomyelitis - Enlarged lymph nodes may be present

Causes and Risk Factors - Bacterial infection - Fungal infection - Trauma or injury to the bone - Surgical procedures - Bloodstream infection - Diabetes - Compromised immune system - Intravenous drug use - Chronic skin ulcers - Recent surgery or trauma

Pathogenesis and Diagnosis - Infection can occur via the bloodstream, nearby areas of infection, or penetrating trauma - The metaphysis of the bone is usually affected when infection is contracted through the bloodstream - Leukocytes enter the infected area and release enzymes that lyse the bone - Pus spreads into the bone's blood vessels, impairing their flow - Chronic osteomyelitis can lead to bone sclerosis and deformity - Diagnosis is suspected based on symptoms and basic laboratory tests - C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are commonly used tests - Plain radiographs are usually unremarkable in the first few days following acute infection - Blood tests, medical imaging, or bone biopsy can confirm the diagnosis - Diagnosis may also involve assessing risk factors such as diabetes or prior spleen removal

Treatment Options - Bacterial osteomyelitis often requires antimicrobials and surgery - In people with poor blood flow, amputation may be necessary - Fungal osteomyelitis requires antifungal medications - Neglected fungal osteomyelitis may require amputation or large bony resections - Treatment outcomes of bacterial osteomyelitis are generally good when caught early, with a low mortality rate - Prolonged antibiotic therapy - Surgical debridement in severe cases - Use of PICC line or central venous catheter for intravenous medication - Regional differences in common infective organisms determine initial antibiotic choice - Hyperbaric oxygen therapy as an adjunct treatment

Complications and Other Information - Chronic infection that is difficult to treat - Bone deformities or limb length discrepancies - Spread of infection to surrounding tissues or joints - Septicemia or bloodstream infection - Development of abscesses or pus-filled pockets - Greek origins of the word osteomyelitis - Thomas Eakins' depiction of a surgical procedure for osteomyelitis - Canadian politician Tommy Douglas' experience with osteomyelitis - Douglas' surgeries performed for free in exchange for medical student observation - Douglas' impact on healthcare in Canada - Osteomyelitis studied by paleopathologists - Evidence of osteomyelitis in fossils of Allosaurus fragilis - Association of osteomyelitis with the first evidence of parasites in dinosaur bones