This study demonstrates the essential similarity of pelvic osteomyelitis to the more common osteomyelitic manifestations in the long bones. However, pelvic localization is distinguished by its anatomic situation, as defined by the peculiar developmental configuration of the innominate bone and its relation to the adjacent fascial spaces, viscera and the hip joint. These features anticipate the differential diagnostic problems encountered. It is characteristic of the disease that the primary lesion is overlooked or subordinated to the predominant simulative signs and symptoms or to the more extensive secondary parosteal purulent infiltrations. Therefore, pyogenic osteomyelitis of the pelvis continues to challenge diagnosis and treatment during its earlier, more favorable stages, although it is a relatively common devastating disease.
In a series of 1,496 cases of pyogenic osteomyelitis, there were 90, or 6 per cent, in which the focus of infection was in the pelvis. This lesion was third in the order of