Osteomyelitis (Bone Infection)

Overview

Osteomyelitis is an infection of the bone that can be acute or chronic, and it represents one of the most challenging conditions in orthopaedic surgery. The infection may reach the bone through the bloodstream (haematogenous spread), from adjacent infected tissue, or directly during surgery or trauma (particularly in open fractures). Chronic osteomyelitis is notoriously difficult to eradicate and often requires a combination of prolonged antibiotic therapy and surgical intervention. Dr. Hannan's experience with complex trauma at Mayo Hospital and Naseer Hospital has given him significant exposure to the management of these difficult cases.

Symptoms and Diagnosis

Symptoms of osteomyelitis can include persistent bone pain, swelling, warmth and redness over the affected area, fever, drainage of pus from an open wound, and general malaise. Diagnosis involves a combination of blood tests (elevated inflammatory markers), imaging studies (X-rays, MRI, and sometimes bone scans), and in some cases, bone biopsy to identify the specific organism causing the infection. Accurate identification of the causative organism is critical for directing antibiotic therapy.

Treatment Approach

Treatment of osteomyelitis typically involves a staged approach. Acute osteomyelitis may respond to intravenous antibiotics alone if diagnosed early. Chronic osteomyelitis almost always requires surgical debridement — removal of all dead and infected bone tissue — combined with targeted antibiotic therapy based on culture results. In severe cases, reconstruction may be needed after the infection is controlled, using techniques such as bone grafting, bone transport, or the Masquelet technique. Dr. Hannan manages this process systematically, coordinating with infectious disease specialists where needed, to achieve the best possible outcome.