In osteomyelitis – colloquially called bone marrow inflammation – (thesaurus synonyms: Acute hematogenous osteomyelitis; Acute osteomyelitis; Acute osteomyelitis in periostitis; Acute septic osteomyelitis; Avascular idiopathic bone necrosis; Brodie abscess; Chronic hematogenous osteomyelitis n.d. ; Chronic multifocal osteomyelitis; Chronic osteomyelitis; Chronic osteomyelitis in periostitis n.d. ; Chronic osteomyelitis with drainage sinus; Chronic osteomyelitis with bone fistula; Chronic bone abscess; Dactylitis with bone involvement; Diaphyseal inflammation; Diaphysitis; Diffuse periostitis; Garré osteomyelitis; Garré syndrome; Osteomyelitis of femoral head; Infectious osteomyelitis; Infectious periostitis; Bone suppuration; Bone inflammation; Bone granuloma; Bone granuloma due to residual foreign body; Bone infection a. n.k. ; Bone marrow phlegmon; Bone sequestrum; Bone ulcer; Congenital periostitis; Nonpurulent osteomyelitis; Osteomyelitis; Osteomyelitis of the hip; Osteomyelitis of the femur; Osteomyelitis of the foot; Osteoperiostitis; Ostitis; Pericranial suppuration; Periosteal abscess; Periosteal abscess with acute osteomyelitis; Periosteal abscess with chronic osteomyelitis; Periosteal abscess with osteomyelitis; Periostitis; Periostitis of the heel; Periostitis with osteomyelitis; Periostosis with osteomyelitis; Pott’s tumor; Pott’s tumor; Temporal bone osteomyelitis; Scapular abscess; Septic osteomyelitis; Sesamoiditis; Sclerosing garré osteitis; Sclerosing nonpurulent osteomyelitis; Sclerosing nonpurulent osteitis; Styloiditis radii; Styloiditis ulnae; Subacute osteomyelitis; Subacute osteomyelitis in periostitis; Subperiosteal bone abscess; Suppurative osteomyelitis; Trochanteric abscess; Circumscribed periostitis; ICD-10 M86. -: Osteomyelitis) is an inflammation of the bone (osteitis). It begins in the bone marrow cavity and spreads to bone components and the periosteum. In most cases, an infection with bacteria is responsible for osteomyelitis. Most commonly (in about 75-80% of cases), the pathogens are Staphylococcus aureus and coagulase-negative staphylococci. However, ß-hemolytic A-streptococci, other bacteria, viruses and fungi are also possible pathogens. Depending on how the pathogens entered the bone marrow, the following forms of osteomyelitis are distinguished:
- Exogenous form – In approximately 80% of cases, osteomyelitis occurs after trauma (injury) or surgery (post-traumatic-postoperative acquired form). The pathogens enter the bone from the outside.
- Endogenous form – In approximately 20% is the endogenous form of osteomyelitis, in which it comes to the pathogen seeding from an existing focus of inflammation, such as tonsillitis (tonsillitis) (hematogenous form).
According to the ICD-10-GM, the following forms of osteomyelitis are distinguished:
- Acute hematogenous osteomyelitis (ICD-10-GM M86.0-) – affects almost only children and adolescents (preference for the male sex); usually the hip joint is affected (“infant coxitis”).
- Other acute osteomyelitis (ICD-10-GM M86.1-).
- Subacute osteomyelitis (ICD-10-GM M86.2-)
- Chronic osteomyelitis (COM)
- Chronic multifocal osteomyelitis (ICD-10-GM M86.3-)
- Chronic osteomyelitis with fistula (ICD-10-GM M86.4-)
- Other chronic hematogenous osteomyelitis (ICD-10-GM M86.5-)
- Other chronic osteomyelitis (ICD-10-GM M86.6-)
- Other osteomyelitis (ICD-10-GM M86.8-)
- Osteomyelitis, unspecified (ICD-10-GM M86.9-)
Sex ratio: boys and men are more commonly affected than girls and women. Frequency peak: the exogenous form of osteomyelitis occurs predominantly in adulthood, while the endogenous form predominantly affects children and adolescents. Here, approximately 80% of those affected are under 16 years of age. Course and prognosis: The prognosis of the disease depends primarily on the type of pathogen, the age of the patient and the functioning of the immune system. In children, the chances of recovery are generally better. The acute form can heal completely. Up to 30% of acute osteomyelitides take a chronic course. This variant is much more difficult to treat, may persist for years, as well as relapse (recur).
