A sequestrum is usually a complication of osteomyelitis and represents devascularisation of a portion of bone with necrosis and resorption of surrounding bone leaving a 'floating' piece. The sequestrum acts as a reservoir for infection and as it is avascular is not penetrated by antibiotics. It usually requires excision if cure is to be achieved. 

In some instances the sequestrum becomes encased in a thick sheath of periosteal new bone, known as an involucrum

When the sequestrum is small and surrounded by lucent rim it is known as a button sequestrum. This is not seen only in osteomyelits, but also in eosinophilic granuloma, fibrosarcoma and lymphoma.

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