Dedicated to GALEN (ca 130 - ca 200).
The greatest surgeon of all time, who dominated medical thinking for nearly 1500 years.

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Osteomyelitis 3       A Simple Guide to Osteomyelitis 3           This drawing illustrates the clinical symptoms and signs already discussed of swelling, pain, pyrexia, erythema and lympadenopathy. X-rays of bone in primary osteomylitis may be initially normal, especially in a child, for the first 2 or 3 weeks. In chronic osteomyelitis, on the other hand, it may show considerable bone destruction of the bone with evidence of sequestra or dead bone. An involucrum is the new bone formation in a chronic osteomyelitis, and is the new vascular honeycombed type of bone formed in an attempt of the body to replace dead avascular infected bone. Infection may spread to involve the whole length of the bone. Complications include involvement of the adjacent joints and pathological fractures. In children the attachment of the capsule of the joint will determine as to whether there will be early spread to the joint. In the upper and lower tibia, the attachment of the joint capsule to the epiphysis, plus the protection of the joint growth plate, will usually stop spread to the adjacent knee or ankle joint. On the other hand, the joint capsule in both the upper and lower ends of the femur as well as the upper and lower ends of the humerus is different, as the attachment extends into the metaphyseal region of the bone. As a result, early pyogenic infection of the hip, knee, shoulder and elbow will occur. Urgent decompression of pus is essential in these cases to prevent a pyogenic arthritis and joint destruction.           < Previous Main  Next >   < Prev   Next >

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