Microabscesses as a possible cause of recurrence in chronic osteomyelitis

Abstract

Introduction It is known that the density of the cortical plate of long bones in patients with chronic osteomyelitis changes throughout its extension. However, the nature of structural disorders in the cortical layer outside the inflammation zone has not been studied well. Purpose To study the structural features of the cortical plate of the femur and tibia outside the focus of inflammation to identify microcavities and microabscesses. Material and methods The study is retrospective conducted at one center. Evidence level IV. In 92 patients with chronic osteomyelitis of long bones of the lower extremities, using polypositional radiography and multislice computed tomography (MSCT), the features of radiological morphology of the femur and tibia were studied in order to reveal structural features of the cortical plate and identify microcavities. Results The cause of osteomyelitis in 5 cases was a consequence of hematogenous osteomyelitis, and in 87 cases it developed due to trauma or surgery. The most common location of chronic osteomyelitis was the distal femur and tibia. Anatomical changes in the femur and tibia in all patients had individual differences. Radiological morphological manifestations such as local and general osteoporosis, foci of osteosclerosis, architectonic disorders occurred in all patients. However, the severity of changes in the bone structure was extremely diverse, including the changes in bone density. Conclusion The data obtained indicate that radiological morphological changes in the cortical plate outside the zone of destruction are manifested by formation of microcavities and microabscesses in 15.6 % of patients, what plays an important role in possible recurrence of osteomyelitis.