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January 27, 1945

THE CLINICAL DIAGNOSIS, PROGNOSIS AND TREATMENT OF ACUTE HEMATOGENOUS OSTEOMYELITIS

JAMA. 1945;127(4):212-217. doi:10.1001/jama.1945.02860040022006
Abstract

The title clearly defines the scope of this paper. Etiology will not be discussed; the pathologic changes occurring in bone as revealed by the x-rays have been described by Pierson and Roach.1 It is necessary, however, in order to lay the groundwork for a discussion of the clinical diagnosis and treatment of acute hematogenous osteomyelitis that certain basic features of its etiology and pathology be commented on. The facts presented are based on the study of 295 cases of the disease treated over the period of the last fifteen years.

Hematogenous osteomyelitis is a pyogenic bone infection. The staphylococcus is the offending organism in approximately 90 per cent of all cases, usually the hemolytic Staphylococcus aureus. The next most common organism found in culture is the streptococcus; occasionally a pneumococcus is found. While the staphylococcus is the organism found in 90 per cent of cases as a whole, in

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