Bone infections (osteomyelitis) are extremely difficult conditions to treat. These infections are caused by numerous different bacteria and/or fungus that "set up shop" in a bone or bones. These bacteria can get into the bone in several ways: through holes in the skin, from other parts of the body via the bloodstream, and sometimes from something as routine as getting your teeth cleaned. The mouth is full of bacteria, and in very rare instances, these bacteria can get into the bloodstream and travel to other parts of the body, such as a bone.

The symptoms of an osteomyelitis vary with each case. They can include:

• an open, draining wound over the involved bone
• an area of skin redness pain
• fever may be present
• no symptoms at all

Infection is frequently the cause of non-union of bone.

Osteomyelitis can be diagnosed by history and physical exam of the patient, plain x-rays, and sometimes a bone scan is done. An indium scan involves taking a small amount of the patients blood, "tagging" the white blood cells with indium, and then taking serial x-rays to see where these white blood cells go. Theoretically, these white blood cells, which fight infection, will be concentrated at the site of infection, and appear "hot" on a bone scan.Unfortunately, infection is not the only entity which causes "hot spots" on bone scan.

The "Gold Standard" for diagnosing osteomyelitis is to take a small piece of the bone and culture it. Culturing the bone is done in an incubator, to see what bacteria grow.

Treatment of osteomyelitis must be very aggressive. The infected area must be cleaned out surgically (debrided), and many times antibiotic beads are placed directly in and around the bone. Antibiotic beads look like a strand of pearls. The bead is made of a cement called methylmethacralate, and contain a high concentration of antibiotics. The theory is that the antibiotics leach into the bone at a very high concentration, and help to control the infection. In addition to this, the patient receives intravenous antibiotics (placed into the vein via a catheter). This is typically done at home, and the patient and/or family are instructed in administration of the antibiotics