What does Osteomyelitis mean - in Diabetic feet?

Osteomyelitis is quite simply bone infection, osteo meaning bone and anything with itis is usually infection. So osteomyelitis is bone infection, it can occur in any bones in the feet, It can occur predominantly with an ulcer, secondary to an ulcer, where the infection from the surface tracks through the ulcer and attacks the bone, and it has a high indication where we have bone present in a wound. So you may have seen or heard of this concept of probed bone, and if you see a podiatrist with a speciality of diabetes or if you see the diabetes team and they're investigating an ulcer, somebody often in the team will say, oh can you probe to bone? And probing to bone and being able to feel bone in an ulcer has a high correlation with osteomyelitis. We in Birmingham will x-ray people that we have a suspicion of osteomyelitis, so we take a baseline x-ray and we'll look and we'll look at the x-ray to see if there's any erosion of the bone of the periosteum of the bone to see if there's any bone infection and if we're suspicious of osteomyelitis then we will provide a prolonged course of antibiotics and in our clinic we provide six weeks of antibiotics as a routine for osteomyelitis and we'll do serial x-rays probably again having done one at baseline we'll do one probably again at maybe three or four weeks one maybe at six weeks when the course of antibiotics finishes and if we're thinking that the osteomyelitis is still progressing we might continue those in those antibiotics or we might stop the antibiotics at that point and see what happens or we might change those antibiotics for a different antibiotic. Sometimes if we think the osteomyelitis isn't responding the surgeons might do some toe sparing surgery so they might remove the infected bone whilst leaving the toe intact and we get very good results with that because we remove the focus for the infection, we remove the osteomyelitic bone and sometimes with osteomyelitis the bone, the infection will erode the bone and the bone becomes very fragile and fragmented and starts to crumble which sounds quite horrible but in a way can be quite a good thing because it means we can remove those fragments of crumbled bone, those fragments of osteomyelitis and that focus for infection and sometimes if we can remove all of those fragments of bone the ulcer will then go on to heal.