• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.4
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• pp.215-220
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• 2016

In prolonged chronic osteomyelitis, chronic inflammation and low-grade infections can result in new periosteal bone formation. Chronic osteomyelitis with proliferative periostitis (traditionally termed $Garr{\acute{e}^{\prime}s$ sclerosing osteomyelitis) mainly affects children and young adults. Here, we present two rare cases of an 11-year-old and a 12-year-old patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such as dental caries or periodontitis. The source of infection was likely to be related to the development of a lower right third molar germ with follicular space widening. Management involved antibiotics and the removal of the third molar germ and surgical debridement. Disease remission and a normal appearance was observed at the six-month follow-up visit.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.2
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• pp.68-75
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• 2019

Chronic recurrent multifocal osteomyelitis (CRMO) is one of the most severe form of chronic non-bacterial osteomyelitis (CNO), which could result in bone and related tissue damage. This autoinflammatory bone disorder (ABD) is very difficult for its clinical diagnosis because of no diagnostic criteria or biomarkers. CRMO in the jaw must be suspected in the differential diagnosis of chronic and recurrent bone pain in the jaw, and a bone biopsy should be considered in chronic and relapsing bone pain with swelling that is unresponsive to treatment. The early diagnosis of CRMO in the jaw will prevent unnecessary and prolonged antibiotic usage or unnecessary surgical intervention. The updated researches for the identification of genetic and molecular alterations in CNO/CRMO should be studied more for its correct pathophysiological causes and proper treatment guidelines. Although our trial consisted of reporting items from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), there are very few articles of randomized controlled trials. This article was summarized based on the author's diverse clinical experiences. This paper reviews the clinical presentation of CNO/CRMO with its own pathogenesis, epidemiology, recent research studies, and general medications. Treatment and monitoring of the jaw are essential for the clear diagnosis and management of CNO/CRMO patients in the field of dentistry and maxillofacial surgery.

• The Korean Journal of Nuclear Medicine
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• v.36 no.2
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• pp.143-145
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• 2002

A 49-year-old male patient with a carcinoma of the right pyriform sinus had a whole-body bone scan and gamma camera based F-18 FDG-PET for staging. Tc-99m MDP bone scan depicted diffuse increased uptake in the left femur due to chronic osteomyelitis but no skeletal metastasis. F-18-FDG-PET revealed increased focal bone uptake and uptake in the draining sinus due to chronic osteomyelitis in addition to visualization of the right pyriform sinus carcinoma and right neck nodal uptake. Fluorine-18 fluorodeoxyglucose-positron emission tomography is significantly more accurate than the bone scan in pinpointing chronic osteomyelitis focus and draining soft tissue infection.

• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.53-59
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• 2021

High-voltage electrical burn injuries on the scalp often result in scalp and cranial bone necrosis. Repetitive debridements and rich-vascularized flap coverage of the cranium are required. However, despite successful flap coverage, chronic osteomyelitis of cranial bones may occur. Treatment of chronic osteomyelitis of cranial bones is surgical debridement of the necrotic bone with re-coverage by a well-vascularized flap. The latissimus dorsi musculocutaneous flap is suitable not only for coverage of the cranium after the burn injury, but also for treatment of chronic osteomyelitis of the skull.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.5
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• pp.514-518
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• 2000

Chronic osteomyelitis is often considered difficult to treat and may lead to refratory condition in oral and maxillofacial region. Clinical features of chronic osteomyelitis includes pain, swelling, pus discharge, and radiographic change. There are many kinds of treatment of chronic osteomyelitis. One of the most important factors in treating osteomyelitis are removal of infectious foci and administration of massive antibiotics. Recently we reviewed 29 patients with chronic osteomyelitis who visited in our department and treated successfully with our treatment protocols, consisting of surgical intervention and intravenous antibiotics for 2 weeks, and followed by oral antibiotics for 6 weeks. It is concluded that combination of surgical intervention and antibiotic therapy are sufficient to treat the chronic osteomyelitis in oral and maxillofacial region.

• Journal of Veterinary Clinics
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• v.39 no.3
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• pp.131-137
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• 2022

Osteomyelitis typically occurs because of the direct inoculation of bacteria or fungi after penetrating trauma or surgical contamination or, by extension, from soft tissue infection. Osteomyelitis is rarely reported in wildlife animals, though severe chronic osteomyelitis cases do exist in wildlife owing to the scarcity of medical support in the wild environment. This report describes three cases of chronic osteomyelitis in wild raccoon dogs related to trauma. The typical symptoms of three reported cases were ataxia, stiffness, muscle atrophy, and lethargy. All three cases were relevant to traumatic or severe external injury, and skin infestation caused by ectoparasites was apparent on an ocular inspection. In the radiographic examination, diffuse sites of osteolytic lesions and remarkable periosteal responses were demonstrated around the injured limb in all three cases. Apparent neutrophilia with a left shift, lymphocytosis, and monocytosis in hematological examinations generally indicated chronic infection as shown in case 1 and 3. Treatment was attempted with broad-spectrum antibiotics and non-steroidal anti-inflammatory drugs, such as amoxicillin/clavulanic acid, enrofloxacin, clindamycin, and meloxicam. These treatment options helped improve the overall prognosis of chronic osteomyelitis, but the outcomes did not meet the treatment goal entirely. Osteomyelitis can be extremely challenging to treat, particularly in wild animals, because of their distinctive traits, such as masking phenomenon and uncontrolled exposure to ectoparasites. Earlier diagnosis with a radiographic examination, hematological examinations, and careful patient monitoring, followed by prolonged antibiotic therapy and restricted exercise, are the key factors leading to a better prognosis.

• Journal of Oral Medicine and Pain
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• v.49 no.2
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• pp.35-39
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• 2024

Osteomyelitis of the jaw is an inflammatory process of the bone marrow that is caused by odontogenic local infection and trauma such as tooth extraction and fractures in the oral and maxillofacial region. The clinical signs include pain, swelling, pus formation, and limited mouth opening. Chronic osteomyelitis presents a diagnostic challenge because of the variability of symptoms across different disease stages and varying health conditions of the patients. This report presents a case of osteomyelitis that was misdiagnosed as a temporomandibular joint disorder (TMD) after tooth extraction. The patient was treated for inflammation after tooth extraction in the early stage; however, as the osteomyelitis progressed chronically, symptoms mimicked those of a TMD. The patient was finally diagnosed with osteomyelitis 6 months after tooth extraction. A review of this case and relevant literature revealed the necessity for a differential diagnosis of chronic osteomyelitis that mimics TMD symptoms.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.637-642
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• 2006

Purpose: Incidence of chronic osteomyelitis in femur is lower than that of tibia due to abundantsurrounding soft tissue like muscles and subcutaneous fat. However, if the femur is infected, surgical approach would be very difficult because of surrounding soft tissue and bony defects would be getting larger due to the late detection. Chronic osteomyelitis of femur is an intractable disease with frequent recurrence and remained bone instability in spite of multiple classical operations. Methods: From August 1998 to October 2005, we had 7 cases of fibular osteocutaneous free flap to reconstruct the femur. Those were followed-up for 23 months. All 7 cases were male. 4 cases were in midshaft and the others are distal part of femur. Results: The 7 cases that had not been healed in spite of average 9.1 times previous operations were reconstructed successfully without the recurrence of chronic osteomyelitis. Continuous rehabilitation therapy and brace were very helpful for the ambulation. It took 5.6 months for complete union of bone, and 9.8 months for the ambulation. Conclusion: After wide resection, reconstruction of the femur using fibular osteocutaneous free flap guaranteed bone stability and prevented recurrence of osteomyelitis through rich blood supplying fibula and muscle. Double barrel graft of fibula would be needed in case of the sufficient strength and thickness of femur. We report the successful results of reconstruction of femur with fibular osteocutaneous free flap for chronic osteomyelitis of femur.

• Archives of Reconstructive Microsurgery
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• v.18 no.1
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• pp.16-22
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• 2009

The purpose of this study was to present the clinical result of anterolateral thigh free flap for pretibial soft tissue lesion after chronic tibia osteomyelitis. From December 2006 to September 2008, Five patients were included in our study. 4 of 5 were superficial or localized types of chronic tibia osteomyelitis, based on the classification of Cierny and Mader. Average age at the surgery was 45 years, three were males and two were females. All had a history of chronic tibia osteomyelitis and subsequent pretbial soft tissue lesions coming from previous operations or pus drainage. Pretibial soft tissue defects included small ulcers, fibrotic, bruisable soft tissue and small bony exposures, but not large-sized bony exposures nor active pus discharge. After complete debridement of large sized pretibial soft tissue lesions and decortication of anterior tibial cortical dead bone, anterolateral thigh free flap was applied to cover remained large pretibial soft tissue defect and to prevent the recurrence of infection. All flaps survived and provided satisfactory coverage of soft tissue defect on pretibial region for 16 months' mean follow up period. No patients has had recurrence of osteomyelitis. Anterolateral thigh free flap could be recommend for large sized pretibial soft tissue defect of supreficial or localized types of chronic tibia osteomyelitis after through debridement.

• Archives of Reconstructive Microsurgery
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• v.8 no.2
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• pp.163-169
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• 1999

Purpose : To evaluate the efficacy of free musculocutaneous flap in the treatment of chronic osteomyelitis with drain sinus. Materials and Methods : Eighteen patients (sixteen male and two female) whose average age was 42.6 years were followed for an average of 3.5 years after free musculocutaneous flap for chronic osteomyelitis with drain sinus tract. The period of time between the initial injury and this procedure was average 10.6 years. The patients had an average of 4.1 prior surgical procedure before it. Results : Sixteen(88.9%) of the eighteen free musculocutaneous flap survived, including thirteen of latisimus dorsi flap, three of scapular free flap with muscle, two of medial plantar flap with abductor muscle. Sixteen cases had no evidence of recurrence at follow up. Conclusion : Free musculocutaneous flap is an extremely successful and reliable procedure for the treatment of chronic osteomyelitis with drain sinus. This flap with microvascular anastomses is highly vascularized through its own intrinsic blood vessels, which has the advantage of obliterating dead space and providing improved vascularity to the relatively ischemic recipient site and covering the skin defect.