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Chronic osteomyelitis

Last revised by Dr Jeremy Jones on 15 Sep 2021

Chronic osteomyelitis is a form of osteomyelitis and is defined as 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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Cases and figures

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  • Case 2
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  • Case 3
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  • Case 4: CT
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  • Case 5
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  • Case 6
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  • Case 7
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  • Case 8: distal humerus
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  • Case 9: 4th metatarsal
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  • Case 10: foot
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  • Case 11
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  • Case 12
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  • Case 13: with sequestrum
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  • Case 14: with sequestrum
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  • Case 15: with Brodie abscess
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  • Case 16: maxilla
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  • Case 17
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  • Case 18: calvarial (severe)
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  • Case 19
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