Osteitis: inflamed bones
If there is an inflammation of the outer bone components (osteitis), it is usually a bacterial infection of different origins. If the internal bone marrow is also affected, osteomyelitis is actually present. Inflammation of the bones often also includes inflammation of all bone structures. Symptoms that arise range from pain in the affected areas to general symptoms of illness. Successful treatment and healing is only possible with antibiotic therapy and often with additional surgical interventions.
Brief overview - bone inflammation
- What is bone inflammation? The term bone inflammation stands for an inflammatory disease of the outer layer of bone (osteitis). As an umbrella term, osteeitis also includes inflammation of bone marrow (osteomyelitis) and other bone structures and can also replace the term osteomyelitis.
- What are the symptoms of bone inflammation? Typical complaints include pain in the bones and in the affected regions of the body, as well as non-specific signs of illness that can occur during an infection.
- What causes bone inflammation? In the vast majority of cases, bacterial infection occurs via different pathways, which penetrates to the bone and causes an inflammatory reaction there (bone infection). Other pathogens or other non-infectious underlying diseases are rarely responsible.
- How is osteitis treated? The standard therapy consists of antibiotic treatment that is tailored to the respective pathogen. Often this must be supplemented with surgical interventions to completely remove the pathogens and the infected tissue.
Definition - what is bone inflammation?
In most cases, bone inflammation is a bacterial infection that can result from open injuries or surgery (exogenous osteitis) or spread through the bloodstream and then usually also affects the bone marrow (hematogenous osteomyelitis). Basically, the inflammation can be acute or chronic.
Inflammation of the bones: symptoms
In acute bone inflammation, local signs of inflammation such as redness, swelling and overheating are often seen. The inflammation can also manifest itself as an increased body temperature or fever. Those affected often feel tired and weak.
The long bones of the extremities are often affected and joints can also become inflamed. This can lead to bone pain and joint pain in the affected areas of the body after just a few days.
Chronic bone inflammation leads to mild symptoms or recurring acute episodes of symptoms, which can also be interrupted by symptom-free time intervals. In the course of the disease, an inner capsule can form as part of the body's defense function against bacterial pathogens, which capsule can empty itself outwards. Such purulent secretion is considered a sure sign of bone inflammation.
In an advanced stage of inflammation, the stability of the bone can be significantly impaired and broken bones are possible consequences.
Causes of inflammation of the bones
In principle, a distinction can be made between infectious and non-infectious bone inflammation, whereby an infection is found far more often as the cause than other triggers, such as reduced blood flow or metabolic disorders (for example diabetes mellitus).
In up to eighty percent of illnesses, the inflammation is triggered by an infection on the bone (bone infection). These are mostly bacterial pathogens that reach the bone tissue via an open wound after trauma or surgery. In this context, one also speaks of post-traumatic or post-operative bone inflammation. If an operation involves the insertion of foreign material, such as plates and screws, this can lead to local weaknesses in the immune system and favor inflammatory processes.
More rarely, infection from a distant focus of inflammation reaches the bones through the bloodstream. The latter plays a role, among other things, in spondylitis - a special form of bone inflammation in the spine. Hematogenous spread of bacteria to one vertebra or several vertebral bodies occurs here. Furthermore, children are particularly affected by these endogenous inflammations. The growth plates of the child's bones have not yet been closed and are more susceptible to pathogens in the bloodstream than is the case with adult bones.
The most common bacterial infections are caused by Staphylococcus aureus, streptococci (in children), pneumococci, Escherichia coli and Pseudomonas aeruginosa. Other bacteria or viruses and fungi are - especially in this country - only very rare pathogens of bone inflammation.
Chronic diseases develop over several weeks and months in less than a third of those affected. These are mostly pathogens that grow relatively slowly.
If, based on the symptoms and after a comprehensive clinical examination and patient survey (anamnesis), there is suspicion of bone inflammation, blood samples are usually taken for laboratory analysis. If specific inflammation parameters and immune cells are detected, this also indicates bone inflammation.
In addition, imaging procedures also play an important role in diagnostics. X-rays can show certain changes in the bone structure, but simple procedures such as ultrasound are also used and may show signs of inflammation on the bone earlier than X-ray examinations.
Other imaging methods that are used include computer tomography (CT), magnetic resonance imaging (MRI) or skeletal scintigraphy.
Treatment of inflammation of the bones
When treating bone inflammation, those affected often have to prepare for a longer treatment period. Since most of the cases are bacterial infections, antibiotic treatment is usually essential. To use the correct antibiotic therapy, the triggering bacteria must first be determined. For this, tissue and fluid are taken from a deep wound area. However, pathogen detection is not always possible.
Other therapeutic measures also depend on the form and form of the disease and on age. A different approach is often chosen for children than for adults.
In many cases, treatment with antibiotics is not sufficient and surgical intervention is also necessary to completely remove the pathogens from the infected tissue. Rinsing can be carried out or parts of the bone can be completely removed. In the latter procedure, bone implants are used as replacements.
After such an operation, depending on the location, the affected area is often immobilized for better healing and stabilization, for example using a splint. In some cases, multiple operations are necessary or open wound healing may be advised to reduce the risk of renewed infection. Inflammation can recur years after the first illness and treatment.
If an inflammation of the bones is recognized in good time and treated accordingly, a complete cure is usually possible without permanent damage.
Treatment methods of holistic medicine
Inflammation of the bones is a serious inflammation that primarily requires appropriate specialist treatment. In addition, in consultation with the attending physicians, complementary therapeutic approaches can support the healing process for bone infections.
Tried and tested medicinal plants from naturopathy with anti-inflammatory and antibacterial effects are, for example, angelica or arnica. In addition to some other measures, a still controversial treatment method for non-infectious bone inflammation is hyperbaric oxygen therapy (HBO therapy). (ps, cs)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. rer. nat. Corinna Schultheis
- Professional association for orthopedics and trauma surgery e. V. (ed.): Information portal in orthopedics and accident surgery www.orthinform.de, encyclopedia - bone inflammation (Osteitis), access: 16.09.2019, orthinform.de
- Pschyrembel: Clinical dictionary. 267th, revised edition, De Gruyter, 2017
- Walter, Gerhard, Kemmerer, Matthias, Kappler, Clemens and Hoffmann, Reinhard: Treatment algorithms for chronic osteomyelitis, in: Deutsches Ärzteblatt International Issue 109 (14) / 2012, aerzteblatt.de
- German Society for Trauma Surgery (ed.): 2Sk guideline: Acute and chronic exogenous osteomyelitis of long long bones in adults, as of December 2017, AWMF registry number. 012-033, awmf.org
- Behrendt, Daniel and Josten, Christoph: Osteomyelitis in adulthood, in: Der Chirurg, Issue 85/3 (2014), Der Chirurg
ICD codes for this disease: M86ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.