Chronic osteomyelitis represents a form of osteomyelitis and is a progressive inflammatory process resulting in bone destruction and sequestrum formation. It may present as recurrent or intermittent disease.
It is a result of osteonecrosis caused by disruption of intraosseous and periosteal blood supply during the acute stage of the disease. A dead infected bone fragment becomes separated from viable bone (known as a sequestrum). Infective agents within the devascularised sequestrum become protected from antibiotics and the endogenous immune response, forming a nidus for chronic infection. This may persist for years.
Inhomogeneous osteosclerosis and/or sequestrum formation (necrotic bone) is characteristic of chronic osteomyelitis on plain radiography.
CT may provide information regarding the presence of sequestra, cloaca, cortical destruction and the thickness of the involucrum.
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