41. Osteomyelitis: Traumatic And Atypical Forms

Question 1

Osteomyelitis of the jaw bone

Answer 1

• Infection and inflammation of the bone and bone marrow
• Acute or chronic
• Varied aetiology

Question 2

Etiological factors of osteomyelitis in the jaw bone

Answer 2

• Infantile Osteomyelitis=>Perinatal trauma
• Chronic Diffuse Sclerosing Osteomyelitis=> Hyperactive immunological response
• Garre’s Sclerosing Osteomyelitis=>Over-inflammatory reaction in the periosteum
• Traumatic Osteomyelitis=>Open fractures leading to multiple bacterial infections

Question 3

Clinical features of infantile osteomyelitis

Answer 3

• Swelling of the face=> edema of the eyelids
• Subperiosteal abscesses=> alveolar mucosa and palate
• Systemic signs=> Fever

Question 4

Complications associated with infantile osteomyelitis

Answer 4

• Spread to the eye and brain
• Facial deformities
• Serious damage to jaw growth
• Loss of teeth and bone

Question 5

Teatment for infantile osteomyelitis

Answer 5

• Intravenous antibiotics and drainage of abscess
• Antibiotics =>penicillin and clindamycin recommended

Question 6

Clinical features of chronic diffuse sclerosing osteomyelitis

Answer 6

• Recurrent pain and swelling
• No suppuration or abscess formation
• Intermingled sclerotic and osteolytic lesions

Question 7

Treatment for chronic diffuse sclerosing osteomyelitis

Answer 7

• NSAIDs, corticosteroids, hyperbaric oxygen therapy
• Muscle relaxants

Question 8

Clinical features of Garre’s sclerosing osteomyelitis

Answer 8

• Localized, unilateral, hard mandibular swelling=> Little tenderness
• Episodic pain w/ dormant periods
• Facial asymmetry

Question 9

Treatment for Garre’s sclerosing osteomyelitis

Answer 9

• Elimination of the cause of infection =>
• Tooth extraction or endodontic treatment

Question 10

How traumatic osteomyelitis is classified

Answer 10

• Stage 1=>Medullary osteomyelitis (confined to the medullary cavity)
• Stage 2=>Superficial osteomyelitis (involves only the cortical bone)
• Stage 3=> Localized osteomyelitis (involves both cortical and medullary bone)
• Stage 4=> Diffuse osteomyelitis (involves entire thickness of the bone with loss of stability)

Question 11

Clinical features of traumatic osteomyelitis

Answer 11

• Pain, edema, swelling, and erythema=>
• At site of previous surgery or trauma

Question 12

Treatment for traumatic osteomyelitis

Answer 12

• Surgical debridement
• Systemic and local antibiotic treatment