Osteomyelitis is an acute or chronic infl ammatory proces
medullary spaces or co ical su aces of bone that extend
the initial site of involvement
osteomyelitis cases are caused by bacterial infections and
expanding lytic destruction of the involved bone, with su
and sequestra formation
Osteoradionecrosis is excluded from this discussion beca
primarily a problem of hypoxia, hypocellularity, and hypo
in which the presence of bacteria represents a secondar
colonization of non healing bone rather than a prima
infection
Tobacco use, alcohol abuse, IV drug abuse, diabetes mell
exanthematous fevers, malaria, sickle cell anemia, malnut
malignancy, collagen vascular diseases, and AIDS have be
associated with an increased frequency of osteomyelitis
, Acute suppurative osteomyelitis
Acute suppurative osteomyelitis exists when an acute in
process spreads through the medullary spaces of the bo
cient time has passed for the body to react to the prese
ammatory infi ltrate
Dental infection is the most frequent cause of acute osteo
CLINICAL AND RADIOGRAPHIC FEATURES
Patients of all ages can be affected by osteomyelitis. The
strong male predominance
cases involve the mandible. Maxillary disease becomes im
primarily in pediatric patients
1 month in duration. Fever
leukocytosis, lymphadenopathy, signifi cant sensitivity, an
tissue swelling of the affected area may be present
Regional lymph nodes are enlarged and tendered in mos
radiographs
demonstrate an ill-defi ned radiolucency
. Periosteal new bone formation also may be seen in resp
subperiosteal spread of the infection.
This proliferation is more common in young patients and
a single-layered linear radiopaque line separated from the
co ex by an intervening radiolucent band
A fragment of necrotic bone that has
, necrotic bone may become surrounded by new vital b
as an involucrum
HISTOPATHOLOGIC FEATURES
The bone shows a loss of the osteocytes from their lacu
peripheral resorption, and bacterial colonization
The periphery of the bone and the haversian canals co
necrotic debris and an acute infl ammatory infiltrate con
of polymorphonuclear leukocytes
The inflammatory
cells are chiefly
polymorphonuclear
leukocytes, but may
show occasional
lymphocytes and
plasma cells
TREATMENT AND PROGNOSIS
medullary spaces or co ical su aces of bone that extend
the initial site of involvement
osteomyelitis cases are caused by bacterial infections and
expanding lytic destruction of the involved bone, with su
and sequestra formation
Osteoradionecrosis is excluded from this discussion beca
primarily a problem of hypoxia, hypocellularity, and hypo
in which the presence of bacteria represents a secondar
colonization of non healing bone rather than a prima
infection
Tobacco use, alcohol abuse, IV drug abuse, diabetes mell
exanthematous fevers, malaria, sickle cell anemia, malnut
malignancy, collagen vascular diseases, and AIDS have be
associated with an increased frequency of osteomyelitis
, Acute suppurative osteomyelitis
Acute suppurative osteomyelitis exists when an acute in
process spreads through the medullary spaces of the bo
cient time has passed for the body to react to the prese
ammatory infi ltrate
Dental infection is the most frequent cause of acute osteo
CLINICAL AND RADIOGRAPHIC FEATURES
Patients of all ages can be affected by osteomyelitis. The
strong male predominance
cases involve the mandible. Maxillary disease becomes im
primarily in pediatric patients
1 month in duration. Fever
leukocytosis, lymphadenopathy, signifi cant sensitivity, an
tissue swelling of the affected area may be present
Regional lymph nodes are enlarged and tendered in mos
radiographs
demonstrate an ill-defi ned radiolucency
. Periosteal new bone formation also may be seen in resp
subperiosteal spread of the infection.
This proliferation is more common in young patients and
a single-layered linear radiopaque line separated from the
co ex by an intervening radiolucent band
A fragment of necrotic bone that has
, necrotic bone may become surrounded by new vital b
as an involucrum
HISTOPATHOLOGIC FEATURES
The bone shows a loss of the osteocytes from their lacu
peripheral resorption, and bacterial colonization
The periphery of the bone and the haversian canals co
necrotic debris and an acute infl ammatory infiltrate con
of polymorphonuclear leukocytes
The inflammatory
cells are chiefly
polymorphonuclear
leukocytes, but may
show occasional
lymphocytes and
plasma cells
TREATMENT AND PROGNOSIS
