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Intracortical fissuring in osteomyelitis

R A Rosen, H T Morehouse, H J Karp

    Radiology
    |October 1, 1981
    PubMed
    Summary

    Cortical fissuring is an early radiographic sign of osteomyelitis, indicating infection spread before bone destruction is visible. This finding, previously linked to sickle cell anemia, is now shown to occur in other contexts.

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    Area of Science:

    • Radiology
    • Orthopedics
    • Pathology

    Background:

    • Osteomyelitis is a bone infection often diagnosed through radiographic evidence.
    • Cortical fissuring is a known radiographic sign associated with osteomyelitis.
    • Historically, cortical fissuring has been linked to sickle cell anemia.

    Observation:

    • This study presents three cases illustrating cortical fissuring in early-stage osteomyelitis.
    • The radiographic sign was observed before significant bone destruction or periosteal reaction was evident.
    • Cortical fissuring indicates infection spread via the haversian system, leading to osteoclastic bone resorption.

    Findings:

    • Cortical fissuring can be an early indicator of osteomyelitis.
    • The presence of cortical fissuring does not exclusively point to sickle cell anemia.
    • Only one of the three presented cases had sickle hemoglobin, challenging previous associations.

    Implications:

    • Recognizing cortical fissuring in its early stages can lead to prompt diagnosis and treatment of osteomyelitis.
    • This finding expands the differential diagnosis for cortical fissuring beyond sickle cell anemia.
    • Further research may elucidate the specific mechanisms and broader clinical relevance of early cortical fissuring in osteomyelitis.

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