If you have a longstanding open wound, or an ulcer, then there is a chance that the bone underlying the sore may be infected in your foot. It is important to know if there is an underlying bone infection, or osteomyelitis, so that your doctor can accurately treat the bone infection.
How does the Doctor determine if a bone infection is present?
But how can the doctor determine if the bone is infected, or is it just a soft tissue infection around the sore? Your doctor will take an X-ray of the foot which shows the bone underlying the sore. There are certain changes to the bone that can be seen on the X-ray that will indicate a bone infection. If there are no changes on X-ray but your doctor still suspects a bone infection, you may need to get an MRI of the foot. An MRI can show bone marrow changes that may indicate an infection. If this is still inconclusive, then the doctor may have to take a bone biopsy, or a tiny piece of the bone and send it to the lab to see if it grows any bacteria.
How does the Doctor treat a bone infection?
Bone infections (also called osteomyelitis) can be treated a couple of different ways.
The main two ways to look at these is surgical or non-surgical. Non-surgical treatment is often sought to reduce recovery from surgery or in efforts of limb salvage. This involves a team approach by your podiatrist and an infectious disease team, as well as sometimes a vascular surgeon. Treatment is with long-term use of IV antibiotics, which involves placement of a needle in the arm that serves as a portal for daily doses of antibiotics for a period of 6-8 weeks. The podiatrist helps monitor infection during this time and often is working to help heal an open sore. The benefits are surgery avoidance and sometimes preservation of toes and other body parts.
Surgical treatment for bone infection involves antibiotics, though not always with an IV, and removal of the infected bone. This is thought to be the more definitive cure, as the infection is literally removed, leaving only healthy and non-infected tissue behind. It sometimes requires loss of a toe or portion of the foot, which is a cosmetic disadvantage. That being said, some non-surgical treatments later require surgical treatments as infected bone is damaged bone and damaged bone is susceptible to re-infection.