class notes on osteomyelitis

OSTEOMYELITIS

INTRODUCTION

 The word “osseous” in Greek means bone.
 “Myelos ” means marrow
 “Itis” means inflammation
 It is the inflammation of bone and its marrow content.




STRUCTURE OF BONE

• Bone marrow- cancellous bone , rich in osteoblastic precursor cells, RE cells, erythrocytes,
granulocytes and platelets.

• Cortical bone- dense bone , containing trabecular system connecting bone marrow with the
cortical bone.

• It consists of longitudinally oriented canals known as haversian system consisting of the central
canal which contains the nutrient blood vessels.

• The haversian systems are connected by Volkmann’s canal.



AETIOLOGY

Odontogenic infections

a. Periapical or periodontal

b. Pericoronitis

c. Infected socket

d. Infected cysts

e. Tumour

Trauma

a. Compound fracture

b. Surgery

, Infections of orofacial region

a. Periostitis following gingival ulcerations

b. Lymph node infections from furuncle

c. Lacerations

d. Peritonsillar abscess

Haematogenous route

a. Furuncle on face

b. Wound on skin

c. Upper respiratory tract infection

d. Mastoiditis

e. Systemic tuberculosis



PREDISPOSING FACTORS

• Virulence of microorganisms.

• Conditions affecting host resistance. Like diabetes, malnutrition, severe anemia, chronic
alcoholism

• Conditions affecting jaw vascularity. like radiation, osteoporosis, bone malignancy



CLASSIFICATION

According to organism specificity

• Tuberculous

• Actinomycotic

• Nonspecific to causative microoraganism

Based on duration

Acute osteomyelitis

 Acute subperiosteal

 Acute periostitis

Chronic osteomyelitis

 Chronic intramedullary