Different classifications of osteomyelitis
• Hematogenous: usually monomicrobial, more common in children; typical route for vertebral osteomyelitis/discitis in adults.
• Contiguous spread: usually polymicrobial.
• Acute: osteomyelitis prior to the development of dead bone (sequestra); can be treated with antibiotics +/– surgery.
• Chronic: osteomyelitis often caused by trauma, diabetic or decubitus ulcers, and infected total joints. Defined by the presence of sequestra. Other indications of chronic osteomyelitis are involucrum (new bone growth around areas of sequestra), sinus tracts, and bone loss. Treatment requires surgical resection of sequestra followed by antibiotics.
