PATHOPHYSIOLOGY OF OSTEOMYELITIS

HOST AGENT ENVIRONMENT

Microorganism (specific?) enters blood

through injury of integument

Lodges into area where circulation slows down

Microorganisms reproduce

Infection lodges in medullary cavity, Histamine released by mast cells

cortex and periosteum

Increased vessel permeability Vasodilation

Pus formation by neutrophils and
macrophages
Increased blood flow to area
Leakage of clotting proteins to tissues Leakage of fluid into interstitial space
Bone abscess formation
Heat, redness
Excessive thrombosis Edema and pain

Pus reaches haversian canal

Starvation of bone of blood Ischemia

Bone necrosis

Formation of new bone around abscess Separation of devitalized bone from living bone

Involcrum formation Sequestrum formation

Active reproduction of
microorganism in sequestrum

Development of sinus tracts Enlargement of sequestrum Sequestrum moves out of soft tissue
 Scar tissue formation Revascularization of bone

Site for continued microorganism growth Removal of sequestrum by normal

immune process

Remission and exacerbation Production of recurrent abscess Healing and recovery

Recurrent drainage in sinus tracts

Excessive vascular insufficiency

from thrombus formation Arrested growth of extremity

Ischemia in limbs

Loss of organ function Gangrene