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Osteomyelitis originating in and around bone infarcts: giant sequestrum phenomena
M F Blacksin1, K C Finzel, J Benevenia
1Department of Radiology, University of Medicine and Dentistry of New Jersey, University Hospital, Rm. C320, 150 Bergen St., Newark, NJ 07103-2426, USA.
Objective:
We describe four cases of osteomyelitis that occurred in and around foci of preexisting osteonecrosis in the medullary cavity. Although sequestration is a well-known complication of osteomyelitis, there is little information known about infection occurring in proximity to large regions of already necrotic bone.
Conclusion:
Osteomyelitis and bone infarction can be seen in the same patient population. Medullary infarcts may function as sequestra, predisposing patients to osteomyelitis and soft-tissue infection.
Insights
Osteomyelitis can develop within bone infarcts, which are areas of necrotic bone. These bone infarcts may act as sequestra, increasing the risk of osteomyelitis and soft-tissue infections.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Bone Pathology
Background:
- Osteomyelitis is a bone infection.
- Osteonecrosis is bone death.
- Sequestration is a complication of osteomyelitis where dead bone separates from living bone.
Purpose of the Study:
- To describe cases of osteomyelitis occurring within preexisting osteonecrosis.
- To investigate the relationship between bone infarction and osteomyelitis.
Main Methods:
- Case series describing four patients.
- Clinical and radiological review of patients with osteomyelitis and osteonecrosis.
Main Results:
- Four cases of osteomyelitis in proximity to medullary osteonecrosis were identified.
- Bone infarcts were observed to function similarly to sequestra.
Conclusions:
- Osteomyelitis and bone infarction can coexist in patients.
- Medullary infarcts can predispose patients to osteomyelitis and soft-tissue infections, acting as sequestra.
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