Introduction of the Disease
Do what you love. Know your own bone; gnaw at it, bury it, unearth it, and gnaw it still.
Osteomyelitis is a local or generalized pyogenic disease of the bone, bonemarrow and surrounding tissue. In children, the disease usually results from untreatedacute hematogenous osteomyelitis. Chronic osteomyelitis may also be seen after traumatic injuries, especially in times of civil unrest or war, or as a complication of surgical procedures such as open reduction and internal fixation of fractures. The longbones are affected most commonly, and the femur and tibia account for approximatelyhalf of the cases. Predisposing factors include poor hygiene, anemia, malnutrition, anda coexisting infectious disease burden (parasites, mycobacteria, acquired autoimmunedeficiency syndrome), or any other factors that decrease immune function. Chronicosteomyelitis is defined by the presence of residual foci of infection (avascular bone andsoft tissue debris), which give rise to recurrent episodes of clinical infection. Eradication of the infection is difficult, and complications associated with both theinfection and their treatments are frequent. Our goals are to review the pathophysiology,natural history, and management for children with chronic osteomyelitis within thecontext of a developing world setting.