ABSTRACT
Osteomyelitis is an old disease, identified in dinosaur bones, early hominids and skeletons from ancient civilisations. It is named from the components of the disease and is caused by bacterial invasion of the bone. Worldwide, acute infection of bones and joints remains common in children. Orthopaedic infection can present acutely, with major systemic upset, local inflammation and purulence, or insidiously, with gradual bone destruction leading to loss of function and slowly evolving local symptoms, with or without systemic features. The infected bone reacts to the infection by separating dead fragments of bone and forming sinuses to drain pus and discharge small bone fragments. Plain radiographs can demonstrate dead bone, periosteal reaction, involucrum formation and loosening of implants. However, they are often normal in the first few days of infection. Good treatment starts with a reliable microbiological diagnosis.
