Localized pyogenic osteomyelitis occurs most often as a complication or sequel of a diffuse osteomyelitic lesion, although it may be the primary focus of bone infection. There is considerable variation in the symptoms that it produces. It usually begins acutely, with continuous pain in the involved region, followed soon by local tenderness, swelling and mild general symptoms of pyogenic infection. The local and general symptoms subside gradually in from one to three weeks, and may entirely disappear. More frequently, a slight local disturbance persists, and occasionally pus collects in the adjacent soft parts. After a period of quiescence, varying from a few weeks to a few months, there is usually a recurrence of symptoms, and this process may be repeated indefinitely unless proper surgical relief is given. Night pain is a common symptom during the periods of recurrence. Occasionally in primary localized osteomyelitis, the course from the onset is that
PHEMISTER DB. SILENT FOCI OF LOCALIZED OSTEOMYELITIS. JAMA. 1924;82(17):1311–1315. doi:10.1001/jama.1924.02650430001001
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