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Virtually any pathogenic bacteria can cause osteomyelitis under the right circumstances. Typically, these organisms find a culture site in a hematoma from recent trauma or in a weakened area, such as the site of surgery or local infection (for example, furunculosis), and spread directly to bone. As the organisms grow and form pus within the bone, tension builds within the rigid medullary cavity, forcing pus through the haversian canals. This forms a subperiosteal abscess that deprives the bone of its blood supply and may eventually cause necrosis. In turn, necrosis stimulates the periosteum to create new bone (involucrum); the old bone (sequestrum) detaches and works its way out through an abscess or the sinuses. By the time sequestrum forms, osteomyelitis is chronic.
Osteomyelitis occurs more commonly in children (especially boys) than in adults — usually as a complication of an acute localized infection. The most common sites in children are the lower end of the femur and the upper end of the tibia, humerus, and radius. The most common sites in adults are the pelvis and vertebrae, generally as a result of contamination associated with surgery or trauma. Other common sites are sternoclavicular, sacroiliac, and symphysis pubis. The incidence of both chronic and acute osteomyelitis is declining, except in drug abusers. With prompt treatment, the prognosis for acute osteomyelitis is very good; for chronic osteomyelitis, which is more prevalent in adults, the prognosis is still poor.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Incidence of 0.016% per year
Source: The 5-Minute Pediatric Consult, 2008
The term 'prevalence' of Osteomyelitis usually refers to the estimated population of people who are managing Osteomyelitis at any given time. The term 'incidence' of Osteomyelitis refers to the annual diagnosis rate, or the number of new cases of Osteomyelitis diagnosed each year. Hence, these two statistics types can differ: a short-lived disease like flu can have high annual incidence but low prevalence, but a life-long disease like diabetes has a low annual incidence but high prevalence. For more information see about prevalence and incidence statistics.
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