Chronic Osteomyelitis

What is chronic Osteomyelitis?

Chronic osteomyelitis is a bone infection that doesn’t go away with treatments. It causes bone pain and recurring drainage (pus). Rarely, chronic osteomyelitis doesn’t have symptoms. The infection may go undetected for months or even years.

What causes chronic Osteomyelitis?

Bone infection is most often caused by bacteria. But it can also be caused by fungi or other germs. When a person has osteomyelitis:

  • Bacteria or other germs may spread to a bone from infected skin, muscles, or tendons next to the bone. This may occur under a skin sore.
  • The infection can start in another part of the body and spread to the bone through the blood.
  • The infection can also start after bone injury (open fracture) and bone surgery. This is more likely if the surgery is done after an injury or if metal rods or plates are placed in the bone

What are the consequences of chronic Osteomyelitis?

Symptomes of chronic Osteomyelitis are :

    • Chronic pain
    • an area of erythema around the affected bone
    • chills, low grade fever and general malaise
    • swelling and bone tenderness, 
    • impaired wound healing often associated with tissue necrosis, increased drainage or persistent sinus tracts

1. Symptoms may come and go for years
2. The prevalence of malignant transformation in the setting of chronic osteomyelitis ranges from 1.6% to 23%, and the most commonly affected bones are the tibia and femur. The most frequently observed malignant transformation is squamous cell carcinoma of the skin (Marjolin ulcer)

How can you treat chronic Osteomyelitis ?

Treatment principles in chronic osteomyelitis are:

  1. removal of portions of bone that are infected or dead (debridement)
    1. Drain the infected area. …
    2. Remove any foreign objects. …
    3. Remove diseased bone and tissue. …
    4. improving the quality (vascularization) of the surroundings (muscle flap surgery)
    5. application of local and intravenous antibiotics