OSTEITIS (ostitis, osteitis; Greek osteon a bone + - itis) — an inflammation of a bone. The term is applied seldom. Acute and chronic purulent posttraumatic O., and also hematogenous O., at to-rykh marrow is always surprised, it is accepted to call osteomyelitis (see); Islands with preferential damage of a periosteum call osteoperiostitis (see); at distribution patol, process on all layers of a bone speak about a panosteitis. In nek-ry sources the term «osteitis» unreasonably designate the diseases which are not relating to inflammatory (the deforming Pedzhet's osteitis, a disease of Recklinghausen).
Most often O. arises at an injury of a bone (an open change or after operation for the closed change) owing to hit of purulent microflora in a wound. Less often O. is caused by specific microflora (tubercular, syphilitic O.). Extremely seldom O. is observed at a leprosy, gonorrhea, a pseudorheumatism, a brucellosis, a paratyphoid.
At O. the education in marrowy cavities of granulyatsionny fabric which is followed by more or less expressed phenomena of a rassasyvaniye of bone substance and a reactive osteogenesis is characteristic. Manifestations acute and hron, inflammations of a bone are possible.
At acute O. as a result of dominance of processes of a rassasyvaniye of a bone tissue over processes of its education the centers of destruction of a bone appear. At hron. The lake granulyatsionny fabric has not gnoynonekrotichesky, but proliferative character. Depending on dominance of processes of a rassasyvaniye or an osteogenesis hron. The lake shares on rarefitsiruyushchy and ossifying. Etiol, rarefitsiruyushchy O.'s factor most often is a specific infection (tuberculosis, syphilis, a leprosy). At tubercular, syphilitic and leprose O. granulyatsionny fabric has characteristic signs. Ossifying O., or an inflammatory osteosclerosis, is observed at syphilis (in the tertiary period acquired and late cases of inborn). Often it is accompanied by an osteoperiostitis.
The clinical picture, the diagnosis
Klin, a picture of various forms O. is described in articles Osteomyelitis (see), Osteoperiostitis (see). Most often O. is localized in an epiphysis, metaphyses or a diaphysis of long tubular bones, is more rare in vertebras and short tubular bones.
In O.'s diagnosis, in addition to studying the wedge, symptoms, is important retgenol. a research of the respective site of a skeleton at least in two standard (direct and side) projections. The basic rentgenol, O.'s sign is the destruction of bone substance which is shown on roentgenograms an enlightenment of its shadow. Depression of bone substance at O. has focal character. The destructive center slowly increases in sizes (from several millimeters to several centimeters); on the periphery of the center reactive develops osteosclerosis (see). Education in a destructive cavity of the bone sequester is characteristic of osteomyelitis and tubercular O. At tomographies (see) sometimes find the small destructive centers, invisible on usual roentgenograms, or receive more evident picture of destruction. The lake causes in most cases productive reaction of a periosteum, and sometimes and an endosteum. In this case inflammatory process is characterized by existence of destructive defect in cortical substance of the periosteal imposings causing a thickening of a bone (fig., a). At ossifying O. the bone on the roentgenogram looks condensed and thickened (fig., b). Such picture is observed at Garre's osteomyelitis, syphilis.
O.'s Treatment complex is also defined by its etiology. It usually includes operative measures: necretomy (see), sequestectomy (see), longitudinal and segmented resections of bones, pumping out and processing of a bone cavity by means of ultrasound, the constant pritochno-sucking-away drainage; antimicrobic therapy (antibioticotherapias), sulfanylamidotherapy, chemotherapy effective antiseptic agents, including specific, applied according to indications intravascularly, intramusculary, locally and inside); wide use of proteolytic enzymes (chymotrypsin, papain, etc.); passive and active immunization; physical therapy and fortifying treatment, and also an immobilization of the affected extremity (see. Immobilization ) at the infected changes and nearthroses.
The general principles of prevention of often found traumatic O. include first of all high-quality radical primary surgical treatment of open changes and the most strict observance of an asepsis during the carrying out an osteosynthesis of the closed changes. Specific O.'s prevention consists in early rational treatment inf. diseases.
See also Bone .
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O. M. Markova; G. I. Lavrishcheva (stalemate. An.), S. A. Sviridov (rents.).