Bone and Joint Infections

What are Bone and Joint Infections

Bone infections (osteomyelitis) and joint infections (septic arthritis) occur when bacteria or other germs get inside a bone or a joint. This can happen if you have an infection in another part of your body that spreads through your blood. Germs from your skin or from outside of your body can also cause this type of infection if you have a wound or a broken bone (fracture) that breaks the skin.

Anyone can get a bone infection or joint infection. You may be more likely to get this type of infection if you have a condition, such as diabetes, that lowers your ability to fight infection or increases your chances of getting an infection. Bone and joint infections can cause damage, and they can spread to other areas of your body. They need to be treated quickly.

What are the causes?

Most bone and joint infections are caused by bacteria. They can also be caused by other germs, such as viruses and funguses.

What increases the risk?

This condition is more likely to develop in:

  • People who recently had surgery, especially bone or joint surgery.
  • People who have a long-term (chronic) disease, such as:
    • HIV (human immunodeficiency virus).
    • Diabetes.
    • Rheumatoid arthritis.
    • Sickle cell anemia.
  • Elderly people.
  • People who take medicines that block or weaken the body’s defense system (immune system).
  • People who have a condition that reduces their blood flow.
  • People who are on kidney dialysis.
  • People who have an artificial joint.
  • People who have had a joint or bone repaired with plates or screws (surgical hardware).
  • People who use or abuse IV drugs.
  • People who have had trauma, such as stepping on a nail.

What are the signs or symptoms?

Symptoms vary depending on the type and location of your infection. Common symptoms of bone and joint infections include:

  • Fever and chills.
  • Redness and warmth.
  • Swelling.
  • Pain and stiffness.
  • Drainage of fluid or pus near the infection.
  • Weight loss and fatigue.
  • Decreased ability to use a hand or foot.

How is this diagnosed?

This condition may be diagnosed based on symptoms, medical history, a physical exam, and diagnostic tests. Tests can help to identify the cause of the infection. You may have various tests, such as:

  • A sample of tissue, fluid, or blood taken to be examined under a microscope.
  • A procedure to remove fluid from the infected joint with a needle (joint aspiration) for testing in a lab.
  • Pus or discharge swabbed from a wound for testing to identify germs and to determine what type of medicine will kill them (culture and sensitivity).
  • Blood tests to look for evidence of infection and inflammation (biomarkers).
  • Imaging studies to determine how severe the bone or joint infection is. These may include:
    • X-rays.
    • CT scan.
    • MRI.
    • Bone scan.

How is this treated?

Treatment depends on the cause and type of infection. Antibiotic medicines are usually the first treatment for a bone or joint infection. Treatment with antibiotics may include:

  • Getting IV antibiotics. This may be done in a hospital at first. You may have to continue IV antibiotics at home for several weeks. You may also have to take antibiotics by mouth for several weeks after that.
  • Taking more than one kind of antibiotic. Treatment may start with a type of antibiotic that works against many different bacteria (broad spectrum antibiotics). IV antibiotics may be changed if tests show that another type may work better.

Other treatments may include:

  • Draining fluid from the joint by placing a needle into it (aspiration).
  • Surgery to remove:
    • Dead or dying tissue from a bone or joint.
    • An infected artificial joint.
    • Infected plates or screws that were used to repair a broken bone.

Follow these instructions at home:

  • Take medicines only as directed by your health care provider.
  • Take your antibiotic medicine as directed by your health care provider. Finish the antibiotic even if you start to feel better.
  • Follow instructions from your health care provider about how to take IV antibiotics at home.
  • Ask your health care provider if you have any restrictions on your activities.
  • Keep all follow-up visits as directed by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever or chills.
  • You have redness, warmth, pain, or swelling that returns after treatment.

Get help right away if:

  • You have rapid breathing or you have trouble breathing.
  • You have chest pain.
  • You cannot drink fluids or make urine.
  • The affected arm or leg swells, changes color, or turns blue.

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