Bone & joints
Osteomyelitis
Osteomyelitis overview
Author: Dariusz Borys, M.D.
Last author update: 1 June 2012
Last staff update: 19 January 2022
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Osteomyelitis bone[title]
Table of Contents
Definition / general | Clinical images | Case reports | Radiology description | Radiology images | Gross description | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Borys D. Osteomyelitis overview. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/boneosteomyelitisgeneral.html. Accessed March 23rd, 2023.
Definition / general
- Infection of bone (osteitis) or bone marrow space (myelitis) = osteomyelitis
- Usually pyogenic, fungal or tubercular
- HIV+ patients may be infected by unusual organisms (eg. Mycobacterium avium)
- Radiographically may resemble a neoplasm, particularly after antibiotic treatment
- Severe osteomyelitis is not associated with grade IV sacral decubitus ulcers in non-septic patients; imaging may be misleading (Arch Pathol Lab Med 2003;127:1599)
- May cause secondary AA amyloidosis
Clinical images
Syphilis
- Caused by Treponema pallidum and T. pertenue (yaws)
- Bone involvement more common in congenital syphilis (Int J STD AIDS 1992;3:161); appears at 5th month of gestation in areas of active endochondral ossification (osteochondritis) and periosteum
- Acquired syphilis involves bone in tertiary phase, usually nose, palate, skull, tibia, vertebrae, hands / feet
Case reports
- 6 year old HIV+ child with amebic osteomyelitis (Pediatr Pathol Lab Med 1998;18:89)
- 32 year old woman with infection of mandibular bone graft by Acanthamoeba castellanii (Hum Pathol 1981;12:573)
- 41 year old man with injury to lumbar/cervical region and Phialemonium obovatum infection (Arch Pathol Lab Med 1993;117:841)
- 86 year old woman with draining sinus in tibia (Arch Pathol Lab Med 2002;126:1551)
- Disabling pelvic osteomyelitis caused by Echinococcus granulosus (Enferm Infecc Microbiol Clin 1997;15:391)
- 3 patients with Scedosporium apiospermum (Pseudallescheria boydii) osteomyelitis (Hum Pathol 1998;29:1266)
- Xanthogranulomatous osteomyelitis (J Orthop Traumatol 2012;13:217, Arch Pathol Lab Med 1984;108:973)
Radiology description
- Permeative, destructive lesion with periosteal new bone formation
- Chronic osteomyelitis: may produce focal destruction or focal abscess
- Syphilis: reactive periosteal bone deposition (“saber shin” of tibia)
Radiology images
Contributed by Mark R. Wick, M.D.
Metatarsal Xray
Gross description
- Syphilis: bone destruction and production; necrotic, well defined bone defects of cortex and periosteum surrounded by sclerotic bone
Microscopic (histologic) description
- Syphilis: edematous granulation tissue, plasma cells, granulomas, necrotic bone and new bone production
- Xanthogranulomatous osteomyelitis: prominent foam macrophages arranged in a mosaic pattern with neutrophil infiltration, foam cell formation, numerous plasma cells, fibrin precipitates
Microscopic (histologic) images
Contributed by Mark R. Wick, M.D.
Acute type
Mandible with splendore phenomenon
