Bones and joints are normally sterile areas, but bacteria and other germs can invade them and cause infections. Bone infections can be debilitating and can smolder for years if not properly treated. Joint infections can damage a joint within days. Prompt diagnosis and treatment are important in order to prevent these infections from destroying bone tissue, spreading to other parts of the body, or becoming life-threatening or chronic.

Bones and joints become infected in several ways:

• When bacteria and other germs travel from another body site through the bloodstream (usually after another illness).
• By direct injury, such as a puncture wound or open fracture. Surgery on a bone or joint can also initiate infection.
• In diabetics, through foot sores.
• In people with sinusitis, infection can spread from the sinus cavity to facial bones.

Osteomyelitis, the medical term for a bone infection, is more likely to develop in some bones than in others. In children, osteomyelitis is most common in the long bones of the arms and legs. In adults, the usual sites are the spine, hip, and foot. The risk is higher for people with weak immunity and for those with metal plates, screws, or prosthetic joints in their bones. Persons with joint diseases, such as rheumatoid arthritis, are at increased risk for joint infections.

Signs and symptoms of a bone infection include:

• Nagging bone pain, which may be deep and dull or sharp when touched. Pain typically worsens with movement and is not helped by pain relievers or rest.
• Tenderness, particularly in bones near the skin surface.
• Fever and chills, especially in children.

Signs and symptoms of a joint infection may include:

• Sudden, intense pain in a joint, especially when you bend it.
• Redness, swelling, and warmth around the joint.
• Fever and chills.

If you have any of these symptoms, your doctor will probably do an X-ray, bone scan, CT scan, or MRI, as well as blood tests. A biopsy of your bone may be necessary to confirm infection.

Bone and joint infections require immediate treatment with antibiotics. You may need to be treated with an intravenous antibiotic for several weeks before switching to an oral antibiotic. Both bone and joint infections may also require surgery, either to drain the infected joint or to remove infected bone and tissue. Rest and immobilization may also be recommended for a while.