The pathogenesis of adult osteomyelitis.

The pathophysiology and pathologic appearances of adult osteomyelitis are discussed, without reference to childhood hematogenous (metaphyseal) osteomyelitis or chronic osteomyelitis secondary to vascular phenomena such as diabetes or arteriosclerosis. Osteomyelitis as a feature of generalized sepsis in the immunocompromised patient is also excluded. The focus is on infection of the adult skeleton that occasionally arises spontaneously but more commonly presents as a complication of an open fracture or an operative procedure. The special features of adult osteomyelitis that are the result of the infection developing within the confined and rigid structure of the skeleton are highlighted. Lastly, the histopathology of osteomyelitis is examined in an effort to demonstrate the host bone's response to this injury.