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Kids Health Info

Osteomyelitis

  • Osteomyelitis (oss-tee-owe-my-eh-lie-tis) is an infection in the bone. The bones most commonly affected are those around the knee, hip or ankle. Osteomyelitis is caused by bacteria entering the bone, often after a minor skin infection, cold or a puncture wound. It is often hard to find out the exact cause.

    Signs and symptoms of osteomyelitis

    Your child may suddenly:

    • have swelling, redness, warmth or pain in the area
    • not want to use the affected area
    • have a fever and generally look unwell.

    A condition with similar symptoms affecting joints is septic arthritis. See our fact sheet Septic arthritis.

    When to see a doctor

    If your child has any of the symptoms of osteomyelitis, see your GP. Your child's doctor may need to:

    • examine your child, especially the painful area 
    • order a bone scan, which is a special X-ray that involves an injection – a normal X-ray will not show the osteomyelitis 
    • order a blood test.

    Treatment for osteomyelitis

    Most children with osteomyelitis will need to be admitted to hospital, where they may be given a plaster or splint to keep the area still.

    • Your child will be given antibiotics directly into a vein through a drip (intravenous or IV therapy). Every child has a different response to treatment and this will affect the amount of time your child needs to stay in hospital.
    • Intravenous antibiotic treatment will continue until your child's condition improves and their temperature is back to normal. After this, your child will need to go on oral antibiotics (tablets or syrup) for three to six weeks.
    • A few children may need longer treatment on intravenous antibiotics (four to six weeks), and sometimes your child might be able to go home from hospital while still having IV therapy.
    • Blood tests will be taken to make sure the right antibiotic is being used and to ensure that your child's condition is improving, even if they are being treated at home.
    • Surgery may be required if antibiotic treatment is unsuccessful, but this is rare.

    Care at home

    It is essential that your child takes the complete course of oral antibiotics that they are prescribed.

    Contact your GP or the treating doctor if any of the symptoms listed under signs and symptoms above return, or if your child develops diarrhoea and/or a fever above 38.5°C.

    Follow-up

    Your child will have a follow-up appointment about one week after going home. It is very important to attend this, even if your child seems to be all better.

    If your child is being treated at The Royal Children's Hospital, you will need to come to the hospital three hours before your appointment so your child can have a blood test to check on their progress. The results of the blood test will then be ready for the appointment.

    Key points to remember

    • Osteomyelitis is an infection in the bone.
    • Your child will need to be treated in hospital, and may need intravenous (into a vein) antibiotics, followed by oral antibiotics.
    • Your child will need regular blood tests to monitor their progress, even after they have gone home.
    • Follow up appointments are very important and your child must attend even if they appear to be well.

    For more information

    Common questions our doctors are asked

    What happens if osteomyelitis is not treated quickly, for instance if it is initially thought to be just a sprained ankle?

    It is important that osteomyelitis is treated early to get rid of the infection and prevent damage to the bone. A sprained ankle won't cause a child to have a fever and become unwell. If a child is in pain and also has a fever and is unwell, they should always see a GP. 

    Will my child's bone be weaker and more prone to breaking after osteomyelitis?

    No. Almost all children will make a full recovery once the treatment for osteomyelitis has finished. It usually occurs just once and most children are not predisposed to having it again.


    Developed by The Royal Children's Hospital Orthopaedics department. We acknowledge the input of RCH consumers and carers.

    Reviewed June 2018.

    This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.


Disclaimer

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.