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Osteomyelitis, Inflammation of The Bone Marrow

Tuesday, July 17th 2012. | Bone Health, Disease

Definition Osteomyelitis

Osteomyelitis means an inflammation of the bone marrow and surrounding bony structures. We distinguish osteomyelitis endogenous (or haematogenous) osteomyelitis and exogenous. It should also differentiate the acute form of the chronic form. Chronic forms are remarkably persistent and can resurface for several years.

Endogenous form, which comes from within: germs spread of existing diseases such as inflammation of the tonsils (tonsillitis), inflammation of the nasal sinuses and dental or skin inflammations. The germs reach the bone marrow through the blood vessels. This form of osteomyelitis particularly affects children and adolescents.

As exogenous, which comes from outside: the exogenous osteomyelitis is a result of accidents (bone lesions) or surgery. Pathogens penetrate from the outside in the bones and spread them. This form of osteomyelitis particularly affects adults.

Osteomyelitis Causes

Risk factors for osteomyelitis occurred the endogenous

  • Circulatory disorders caused by diabetes and arteriosclerosis.
  • Existing inflammations, abscesses (pus) and germs from spreading to the bone marrow via the blood vessels.
  • Infants after an umbilical cord infection (risk of blood poisoning).
  • Weakened immune system in children due to malnutrition.
  • Precipitating factor in children: the closure of epiphyseal line (growth area).
  • Weakened immune system in people with chronic diseases or the elderly.

Risk factors for the occurrence of exogenous osteomyelitis:

  • Accident
  • Surgery
  • Poorly healing wounds, eg. following fracture of the jaw or tooth root abscess.


Osteomyelitis Disorders (symptoms)

Endogenous form acute

  • Fever and weakened general condition. Generally, babies are very sick, high fever, fatigue, chills.
  • Joint pain, to rest
  • Redness, hyperthermia of bone
  • Swelling and limitation of function
  • Abscess formation close to the bone marrow, increasing the risk of spontaneous bone fractures.

Chronic form:

  • Symptoms similar to those of the acute form of flu which attenuated pain more pronounced.
  • Fistula formation through which the pus flows.

Acute exogenous form

  • Pain, fever, flu-like strong following surgery (sign of blood poisoning).
  • Redness, swelling and hyperthermia in the region.

Chronic Form

  • The chronic form is characterized by alternating periods of asymptomatic and painful periods. Painful periods are always accompanied by a feeling of inflammation (see acute). Fistula through which most flows can also form.

Osteomyelitis Examinations (diagnosis)

  • Anamnesis (surgical procedures, accidents) taking into account the patient’s symptoms.
  • Blood tests to demonstrate an inflammatory syndrome (is not very pronounced for the chronic form).
  • Smears at the puncture wound or to identify the pathogen.
  • Ultrasound or CT
  • Radiographs show any fistulas or spontaneous fractures.

Osteomyelitis Treatment Options

General measures

  •      Children and infants should immediately be treated medically.
  •      The area concerned must be put to rest.
  •      Ice creams and refreshing (if there is no open wound) can contribute to deflation of inflammation.
  •      Inflammation that occurred after an accident or surgery should be subject to immediate medical treatment.

Medical drugs

  • Antibiotic treatments (injections, tablets) are generally effective for the endogenous form (internal).
  • Analgesics, anti-inflammatory


  • Generally, when exogenous osteomyelitis, only surgical resection, which involves removing tissue purulent and / or necrotic is useful.
  • Locally: antibiotic compresses
  • In addition, antibiotic tablets or injections

Osteomyelitis Possible Complications

Healing is possible in case of early treatment and appropriate.

When treatment too late or inadequate, the acute form may become chronic. Inflammatory attacks can then resurface for years. In children, impaired growth may result, in infants, acute inflammation of the joints may occur. For this reason it is essential to start treatment as soon as possible.

In cases of more serious joint damage, amputation may be indicated.

Preventive Measures

  • After surgery, the adoption of hygienic measures and the administration of drugs as preventive (antibiotics) are required.
  • Adults with vascular disease should not smoke.
  • In type 2 diabetes, it is necessary to properly regulate blood sugar.
  • Strengthening the immune system by doing sufficient physical activity and adopting a healthy diet.
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