classification of osteomyelitis 1

intramedullary space - inside medullary space

subperiosteal - below periosteum

periosteal - in periosteum

Based on location

acute

chronic

Based on duration and severity

suppurative

non-suppurative

Based on presence or absence of suppuration

suppurative

Acute suppurative osteomyelitis

• Chronic suppurative osteomyelitis

Primary

secondary

Infantile osteomyelitis

chronic non - suppurative

Chronic nonsuppurative

• Focal

• Diffuse

radiation osteomyelitis

caused by radiation therapy: dental clearance is necessary prior to radiation therapy

• Bronchi

• Ronchi - medication induced

garre’s osteomyelitis

periosteum of the bone

osteomyelitis due to specific infection

Like actinomycoses. tuberculosis. syphilis. etc

• Secondary infection of the bone

osteomyelitis

Inflammation of bone and bone marrow

osteomyelitis

Common in long bones such as mandible

osteomyelitis

Low incidence

Common in adult males

infection of dental origin

trauma or injury

bacteremia

virulent mo

Etiology of osteomyelitis

acute osteomyelitis

Acute inflammation of B and BM

acute osteomyelitis

Severe, throbbing. and deep-seated pain

acute osteomyelitis

Swelling - extra-oral and intra-oral

• Teeth - tender. loose. pus may exude from an open socket

• Gingival - inflamed and tender

acute osteomyelitis

Trismus

• Dysphagia

• Lymph nodes - painful and enlarged

• Lower lip - paresthesia (loss of sensation) due to compression of nerve in neurovascular bundle

• Fever - high intermittent

Leukocytosis - slight

acute osteomyelitis

Bacteroides - fragilis, melaninogenicus Porphyromonas. Prevotella species Staphylococci (E/O trauma and

streptococci)

acute inflammation of medullary spaces

purulent exudates in marrow spaces

thrombosis and obstruction

Histology of acute osteomyelitis

radiographic feature of acute osteomyelitis

Bone necrosis (sequestrum)

Increased osteoclastic resorption

Osteocytes are lost

Marrow

undergoes liquefaction

necrosis

radiographic feature of acute osteomyelitis

Initial phase - no radiographic manifestations (socket not healing)

After about 10 days

• Loss of trabecular pattern

• Mixed

radiopacity

and

radiolucency

Small radiolucent areas