Doctors then speak of bone inflammation (osteitis) when there is an infection which – in very many cases – is provided with malignant microorganisms. Operations or open fractures (breaks) increase the risk of bone inflammation. In many cases, radical surgery is the only treatment option when the patient is affected by osteitis.
What is osteitis?
Under osteitis or bone inflammation, the doctor describes a special infection that mainly affects the bone. In osteitis, the Haversian or Volkmann’s canals can be affected. If the Haversian canals are infected with a pathogen, it is an infection in the longitudinal directions of the supply lines of the bone. The nerves and capillaries run in these channels. See usvsukenglish for What does the abbreviation KS stand for.
If the pathogen infection is present in the Volkmann canals, it is an infection in the transverse directions of the bone structures. In many cases, however, osteitis occurs in combination with inflammation of the bone marrow. Due to the fact that osteitis and inflammation of the bone marrow (osteomyelitis) have similar clinical pictures, doctors often use the terms ostitis, osteitis and osteomyelitis as synonyms.
Osteitis occurs due to an infection. Only rarely do foci of infection that have already flared up in the body spread to the bones. In most cases, osteitis occurs as part of an open fracture. The pathogens enter through the open wound, attack the bone and trigger inflammation. Even surgery increases the risk of osteitis. For example, when germs – due to non-sterile instruments – get into the wound and directly onto the bone.
Sometimes viruses and fungi can be the causative agents of bone inflammation; in almost all cases, however, bacteria are responsible for osteitis. Streptococci in particular play an important role. Bacteria that occur as part of a nosocomial infection can also trigger osteitis. These are mainly classic infections that occur in nursing homes and hospitals. It is mainly multi-resistant germs that cannot be combated by antibiotics. Sometimes the pathogens also include strains of Staphylococcus aureus; that strain is the main cause of osteitis.
Symptoms, Ailments & Signs
Classic symptoms are redness and swelling of the affected area. The patient complains of bone pain, has an increased body temperature or suffers from fever. In many cases, those affected are exhausted, report pain in the limbs and joints, and bone fractures can also occur later in the course of the disease. If the osteitis is not treated or treated insufficiently, pus can leak out.
Diagnosis & course of disease
Osteitis is characterized by five classic symptoms of inflammation. Those appear together. These are redness, heat, pain, swelling and functional limitations. If there are open wounds or fistulas, pus formation can be observed. The doctor recognizes osteitis from the blood count. In blood tests, the doctor not only finds a strong inflammatory reaction, but also a significantly increased leukocyte value.
Magnetic resonance imaging provides information about whether bone changes have already occurred. Occasionally necrotic processes may also have occurred. This means that the bone substance dies off. If osteitis is present, only radical operations can promise success. While these are risky, they cannot be postponed or prevented. Depending on the extent of the osteitis, permanent damage or disability can occur.
In most cases, osteitis causes a very large amount of swelling in the affected area of the body. After the fracture of the bone, the patients usually suffer from very severe pain and restricted movement. The person affected may then be dependent on the help of other people in their everyday life.
The osteitis also causes a high fever and general exhaustion in the patient. The resilience also drops significantly and pain occurs in the extremities and joints. The patient’s quality of life is generally significantly reduced by the osteitis. Complications usually occur if treatment is not carried out. The inflammation can also spread to other areas of the body and possibly also penetrate to the outside.
In the worst case, it can also lead to blood poisoning, which can be fatal for the person concerned. Osteitis is usually treated with surgery and antibiotics. As a rule, the course of the disease is positive without complications. The life expectancy of the affected person is usually not affected by the osteitis.
When should you go to the doctor?
If you have bone or joint pain, you should see a doctor. Osteitis is manifested by complaints in the area of the bones, which quickly become more severe and spread as the disease progresses. If the symptoms mentioned appear, the family doctor must be consulted. The doctor can make a diagnosis based on a scintigraphy and inform the patient about the next steps. People who already have bone disease are particularly at risk. There is also an increased risk of disease for older people and patients with genetic predispositions such as deformities.
Likewise, people who suffer from bone cancer or who are unable to move due to an existing condition are at an increased risk of complications and should see their family doctor immediately if they notice the bone pain or joint dysfunction described. Osteitis is treated as an inpatient in a specialist clinic. After the operation, the patient should go for regular follow-up care and, in addition, consult the doctor in the event of unusual symptoms.
Treatment & Therapy
Due to the fact that osteitis is a bacterial infection, antibiotics must be prescribed. In many cases, oral medication is not enough; Infusion drugs are often prescribed, but these do not lead to the desired success. For this reason, the doctor – in almost all cases – has to operate and peel off the affected area of the bone.
The doctor concentrates on the inflamed or already necrotic part of the bone. If stabilizing measures in the form of screws or nails were used as a result of fracture treatment, the physician must remove those instruments. However, the fracture point must still be fixed; new or different instruments are used for this. Disinfectant rinses also take place as part of the operation. The pathogens should be completely removed.
Chains or tamponades soaked in antibiotics then remain in the surgical wound. A drain is also inserted so that the purulent secretions can be drained off. The doctor can sometimes leave the surgical wound open if there is a risk of having to carry out another procedure. Because the intervention does not always bring the desired success and healing of the osteitis. For this reason, a second operation may be necessary.
Even if the healing process has already started and there is a suspicion that there are still foci of inflammation, a second operation can be carried out. Due to the fact that the interventions have caused a loss of substance, this must be compensated for again. Thus, the patient has to work on restoring his mobility. If there is no or insufficient rehabilitation, a disability can sometimes impair mobility.
Outlook & Forecast
The prognosis of osteitis depends on different factors. This includes the age of the affected person, the type of inflammation and the triggering type of bacteria. The strength of the immune system also plays an important role.
The prospects for osteitis are positive if there is acute inflammation of the bone marrow. Bone inflammation can also be healed in most cases without leaving any permanent impairment. However, the basic requirement is an early diagnosis and appropriate professional treatment.
The prognosis is considered less favorable in the case of chronic osteitis. Chronic bone inflammation primarily affects adult patients. On the other hand, the chances of recovery for children are classified as more favourable. However, growth disorders in children must sometimes be expected if the growth plates are affected by the inflammation. The growth plates in children are still made up of cartilage. The cartilage constantly forms new bone substance for growth. However, if this process is disrupted, there is a risk of short stature. Depending on the location of the focus of inflammation, arms or legs may be shortened.
It is not uncommon for the chronic course of osteitis to last for several years. In addition, recurrence is possible. Relapse can occur even years after treatment. Containment of the inflammation by surgical intervention usually has a positive effect on the course.
Osteitis can only be prevented to a limited extent by the person affected; Rather, the hospital – within the framework of hygiene – must ensure that osteitis is prevented. If bone inflammation is suspected, a doctor must be contacted immediately.
In the case of osteitis, the aftercare measures are usually significantly limited. For this reason, the person affected by this disease should consult a doctor very early on, so that there are no further complications or further complaints for the person concerned, which could have a negative impact on the patient’s quality of life. Early diagnosis usually has a very positive effect on the further course of the disease.
In most cases, osteitis disease requires another surgical intervention. After this procedure, the person concerned should take it easy and rest, whereby bed rest is to be observed. The wound should be particularly well protected to prevent further infections and other symptoms.
Regular checks are also very important after the person concerned has been released. As a rule, osteitis does not reduce the patient’s life expectancy if it is recognized and treated in time. Further aftercare measures are usually not available to the person concerned and are also not necessary. In general, however, a high standard of hygiene should be observed.
You can do that yourself
If the diagnosis of osteitis is confirmed, the affected patient should reliably take or have the prescribed medication (antibiotics) taken or infused according to the doctor’s instructions. The doctor may need to operate to prevent sepsis. Despite all therapeutic measures, other foci of inflammation can be active in the body. It is therefore advisable for the patient to also take action against the inflammation.
In orthomolecular medicine, taking the mineral zinc and vitamins C and E is recommended for inflammation, while phytotherapists would recommend herbal remedies such as echinacea, chamomile or linden blossom. A naturopathic doctor can give specific recommendations here. If the inflamed areas are still swollen, they should be cooled. Cool pads or so-called cool pads, which are available in pharmacies, are suitable for this. They should be stored in the freezer compartment of the refrigerator and wrapped with a towel and laid out if necessary. Under no circumstances should the cooling pad come directly onto the skin, otherwise cold burns may occur.
It is important during this time to strengthen the patient’s immune system. This includes a healthy diet rich in vitamins and minerals as well as regular sleep. At the same time, the patient should refrain from taking stimulants such as nicotine, coffee and alcohol. Daily exercise in the fresh air also supports the immune system.