Histopathological Osteomyelitis Evaluation Score (HOES): Pioneering precision for diagnosing jaw osteomyelitis

Osteomyelitis is an inflammatory condition of bone that may arise in response to a foci of infection. A multidisciplinary approach is necessary between the clinician, pathologist, and radiologist to give an early diagnosis for initiating early treatment to prevent lifelong debility.

The objectives of this study were to analyze the applicability of Histopathological Osteomyelitis Evaluation Score (HOES) in diagnosing different stages of jaw osteomyelitis and to compare the HOES method with preoperative and conventional histopathological diagnosis.

In this retrospective study, 40 slides of preoperatively diagnosed cases of osteomyelitis were evaluated semiquantitatively using HOES criteria for acute (A1, A2, and A3) and chronic (C1 and C2) cases based on histopathological changes in the bone, soft tissue, and inflammatory infiltrate. The results obtained were compared and correlated to preoperative diagnosis and conventional histopathological diagnosis by using Chi-square and Spearman's correlation coefficient.

Out of 40 cases, 26 (65%) were men and 14 (35%) were women, with a mean age of 45.1 years (range: 7 to 70 years). The frequency of occurrence was found to be 68% in mandible and 32% in maxilla. Significant association was observed between HOES and conventional histopathological diagnosis (χ ² = 15.91, P < 0.001), as well as HOES and preoperative diagnosis (χ ² = 12.69, P < 0.005). The results of Spearman's correlation revealed 50% correlation of HOES with conventional histopathological diagnosis and 43% with preoperative diagnosis.

HOES serves as a systematic and precise method for classification and differentiation of different stages of osteomyelitis which aids in the stratification of patients for their treatment needs, preventing and halting the progression of disease at an early stage.