ACUTE AND CHRONIC OSTEOMYELITIS: ETIOLOGY, CLINICAL MANIFESTATIONS, PATHOPHYSIOLOGY, AND MODERN TREATMENT APPROACHES

Abstract

Osteomyelitis represents a severe inflammatory condition of bone tissue caused predominantly by microbial infection, characterized by progressive destruction, necrosis, and potential systemic complications. This study aims to provide a comprehensive theoretical and analytical overview of acute and chronic osteomyelitis, focusing on etiology, clinical presentation, pathophysiological mechanisms, and contemporary treatment strategies. Acute osteomyelitis is typically associated with hematogenous bacterial dissemination, most commonly involving Staphylococcus aureus, whereas chronic osteomyelitis develops due to inadequate treatment or persistence of infection, leading to sequestrum formation and long-term morbidity. The pathophysiology involves complex interactions between microbial virulence factors, host immune responses, vascular compromise, and bone remodeling dynamics. Clinically, acute osteomyelitis presents with localized pain, fever, swelling, and systemic inflammatory signs, while chronic osteomyelitis is characterized by sinus tract formation, intermittent discharge, and persistent bone destruction. Epidemiological data suggest increasing incidence rates due to trauma, surgical interventions, and comorbid conditions such as diabetes mellitus. Modern treatment approaches emphasize early diagnosis using advanced imaging techniques and laboratory markers, combined with targeted antimicrobial therapy and surgical debridement when necessary. Emerging strategies include biofilm disruption, local antibiotic delivery systems, and regenerative bone therapies. Multidisciplinary management has significantly improved patient outcomes, although challenges remain in preventing recurrence and managing resistant infections.