Causes of eye socket pain

This is an automatically translated article.

Eye socket pain is a sign that can be encountered in many different diseases. This can be a sign of a dangerous disease and seriously affects vision if not detected and treated early.

1. Eye socket pain is what disease?

The eye socket is composed of many different bones including the maxillary bone, the frontal bone, the cheekbone, the lacrimal bone, the ethmoid bone, and the sphenoid bone. Not only that, the inside of the eye socket also contains soft tissue including the optic nerve, blood vessels, eye muscles, eyeball…
Orbital pain can be caused by many different causes. It can also be a sign of a dangerous disease in the eye such as orbital inflammation, glaucoma, tumor… that needs to be treated early otherwise it will cause many dangerous complications.

2. What causes eye socket pain?

Orbital pain is a sign that can appear due to causes related to the internal organs of the eye socket. This is also a manifestation of some diseases in other organs. Here are the common causes of orbital pain symptoms :
2.1 Orchitis This is a condition caused by an infection of the soft tissues in the orbit and the muscles around the eye by microbiological agents such as bacteria and viruses. bacteria, viruses or fungi.
Orchitis is a disease that can affect the components that make up the orbit. This is a serious condition that, if not treated in time, can lead to irreversible vision loss, and even lead to life-threatening sepsis.
Orbital cellulitis can occur at any age, but is more common in children under 7 years of age and can worsen rapidly in children, increasing the risk of blindness. The manifestations of orbital cellulitis in children include:
Appearance of visual impairment. Swelling and pain in both upper and lower eyelids, possibly with swelling of the eyebrows and cheeks. Change in red or purple eyelid color. Fever over 39 degrees. Difficulty moving your eyes and feeling pain with eye movement Your eyes bulge and feel very sore in the eye sockets. Tired, children refuse to play. 2.2 Tumor in the orbit The tumor can originate from many different tissues and it can compress the nerves in the orbit causing pain in the orbit. Tumors can occur at any age and can be benign or malignant.
Benign tumors: Some benign tumors include hemangiomas, dermoid cysts, fibrous dysplasia in children, optic nerve tumors in adults… Melanoma: Some malignancies including rhabdomyosarcoma, bone malignancy, metastatic cancer, lymphoma…

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2.3 Glaucoma Glaucoma is an eye disease that is more common in the elderly and can be called by different names such as glaucoma, glaucoma. Glaucoma occurs when the pressure in the eye is abnormally high, causing damage to the optic nerve, leading to vision loss or blindness if not diagnosed and treated early.
Glaucoma is mainly divided into 2 types including:
2.3.1. Open-angle glaucoma Open-angle glaucoma usually progresses slowly and gradually increases, it takes a later stage to manifest itself. Symptoms usually appear one eye at a time. Manifestations of open-angle glaucoma may include:
See things more blurred. Reduced visual field of the eye causes tunnel vision. That is, all vision around is lost and only forward vision is visible. Red eyes, eye pain, and eye discomfort Some people may experience headaches. 2.3.2. Angle-closure glaucoma Angle-closure glaucoma can be divided into three categories: acute, subacute, and chronic. In which, chronic angle-closure glaucoma is very rare, often occurs gradually, the symptoms are similar to those of open-angle glaucoma. In the case of acute and subacute angle-closure glaucoma, the onset will be sudden with the following signs:
Visibly reduced vision, seeing a halo of color like when looking at a lightbulb Feeling severe headache, pain in the socket fierce eyes. Eye pain, red eyes. Nausea and vomiting. Irreversible visual impairment due to glaucoma. Therefore, to detect the disease early, it is necessary to have regular eye exams to screen for disease. If detected early, vision loss can be prevented or slowed. The treatment of these two types of glaucoma is completely different, so it is necessary to have an accurate diagnosis of closed-angle glaucoma or open-angle glaucoma to give an appropriate treatment plan.
2.4 Eye trauma After a direct or indirect injury to the eye socket can cause a number of conditions such as hemorrhage of the eyeball, bruising of the organization in the eye, foreign body in the eye socket… Expression of pain Traumatic eye sockets can be caused by many factors. But if you experience orbital pain after an eye injury, you need to see a doctor to find the cause quickly.

2.5 Some infectious diseases Pain in the eye socket is not only a sign of eye diseases but also can be a manifestation of some diseases such as:
Sinusitis: Especially frontal sinusitis is a common cause. pain in the eye socket, which increases when the head is lowered. In addition to symptoms of pain in the eye socket, the patient may have a runny nose and possibly a fever. Dengue fever: This is a viral disease transmitted by mosquito bites. In the early stages, the patient may appear high fever, body aches, pain in both eyes, headache. Viral fever: In addition to dengue fever, some other viral causes of fever can also cause systemic symptoms such as fever, body pain, orbital pain, etc. Infectious diseases often cause high fever and symptoms. The main pain is not orbital pain and the pain may be intermittently intermittent. Unlike orbital inflammation, eye pain is constant and accompanied by other eye symptoms.
2.6 Vasculitis Orbital vasculitis also causes orbital pain and other systemic symptoms such as fever.
2.7 Varicose Veins In the eye socket, if dilated, it will cause blood stagnation, causing the eye to bulge and pain in the eye socket. When having varicose veins in the eye socket, the patient needs to rest and avoid working too much.
2.8 Graves’ disease is an immune-related hyperthyroidism, one of the effects of the disease is to cause protrusion and the cause is not really clear. This condition causes pain in the orbits, bulging eyes, difficulty moving the eyes, feeling dazzled, eyestrain, watery or dry eyes, puffiness, and blurred or double vision. In addition, there are other symptoms such as rapid heart rate, heat, sweating, enlarged thyroid gland, eating a lot and being thin…
2.9 Graves’ disease causing eye socket pain Graves is a thyroid disease that can cause protrusion and glare Eyes, watery, sometimes burning sensation… For lower eyelids can be edematous, may be paralyzed, eyelids can’t be closed, the risk of complications can lead to corneal ulcers, dry eyes.
2.10 Other systemic diseases Some diseases such as high blood pressure, diabetes can cause eye complications and thereby cause orbital pain.

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3. What to do when you have eye socket pain?

Orbital pain has many causes, if you see orbital pain accompanied by symptoms such as blurred vision, severe pain, high fever, bulging eyes, prolonged pain. .. Children who encounter these signs need to to go to medical facilities to be examined and find the cause, get treatment early to limit the risk of complications, if any.
Hopefully through the article you have learned what orbital pain is and how to recognize it in cases that need early treatment to avoid complications. Regular eye exams are very important to help detect diseases that have no obvious symptoms and help patients access early treatment.

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Inflammation of the Orbit – Eye Disorders

By

Richard C. Allen

, MD, PhD, Baylor College of Medicine

Reviewed/Revised Oct 2022

VIEW PROFESSIONAL VERSION

Any or all of the structures within the eye socket (orbit) may become inflamed because of a bodywide inflammatory disorder or an inflammatory disorder that affects only the orbit.

(See also Introduction to Eye Socket Disorders Introduction to Eye Socket Disorders The eye sockets (orbits) are bony cavities that contain and protect the eyes and their supporting structures (see figures An Inside Look at the Eye and Structures That Protect the Eye). Disorders… read more .)

People of all ages can be affected. Inflammation can be brief or long lasting, may or may not be caused by an infection, and can recur.

Inflammation of the orbit can be the result of a bodywide (systemic) inflammatory disorder. Sometimes the inflammation affects only the orbit. Inflammation can be caused by infection or by a noninfectious disorder. Inflammation of the orbit due to infection that affects the eyelid, skin, and tissues around the front of the eye is called preseptal cellulitis Preseptal Cellulitis Preseptal cellulitis is infection of the eyelid and of the skin and tissues around the front of the eye. (See also Introduction to Eye Socket Disorders.) Both preseptal cellulitis and orbital… read more . Inflammation that affects the tissue within the orbit and around and behind the eye is called orbital cellulitis Orbital Cellulitis Orbital cellulitis is infection affecting the tissue within the orbit and around and behind the eye. Infection can spread to the orbit from sources such as the sinuses around the nose. Symptoms… read more . Noninfectious orbital inflammation has many causes. The most common cause of noninfectious inflammation of the eye socket is thyroid eye disease (also known as Graves ophthalmopathy Graves disease Hyperthyroidism is overactivity of the thyroid gland that leads to high levels of thyroid hormones and speeding up of vital body functions. Graves disease is the most common cause of hyperthyroidism… read more ).

Systemic inflammatory disorders that affect the eye/orbit include granulomatosis with polyangiitis Granulomatosis with Polyangiitis Granulomatosis with polyangiitis often begins with inflammation of small- and medium-sized blood vessels and tissues in the nose, sinuses, throat, lungs, or kidneys. The cause is unknown. The… read more (formerly known as Wegener granulomatosis), in which there is generalized inflammation of blood vessels (called vasculitis Overview of Vasculitis Vasculitic disorders are caused by inflammation of the blood vessels (vasculitis). Vasculitis can be triggered by certain infections or drugs or can occur for unknown reasons. People may have… read more ). Another type of inflammation is called IgG4-related orbital inflammation (see also IgG4-Related Disease IgG4-Related Disease Immunoglobulin G4-related disease (IgG4-RD) is an uncommon immune disorder that usually affects multiple tissues and organs with tumor-like masses and/or painless enlargement. Symptoms depend… read more ). IgG4-related orbital inflammation can affect the same structures as granulomatosis with polyangiitis but typically has fewer symptoms.

Inflammatory disorders that affect only the eye include scleritis Scleritis Scleritis is severe, destructive inflammation of the sclera (the tough, white, fiber layer covering the eye) that may threaten vision. Scleritis sometimes occurs in people who have a bodywide… read more , in which the white coat of the eye (sclera) becomes inflamed. Eyelid disorders Eyelid and Tearing Disorders with inflammation are discussed elsewhere. Inflammation affecting any or all parts of the orbit is called inflammatory orbital pseudotumor (which is not really a tumor and is not a cancer) or nonspecific orbital inflammation. Inflammation affecting the tear (lacrimal) gland, located at the upper outer edge of the orbit (see figure ), is called dacryoadenitis. Inflammation affecting one of the muscles that move the eye is called myositis.

Symptoms vary depending on which structures are actually inflamed. In general, symptoms start rather suddenly, typically over a few days. Pain and redness of the eyeball or eyelid usually occur. Pain can be severe and incapacitating at times. Abnormal bulging of the eyes (proptosis Eyes, Bulging Bulging or protruding of one or both eyes is called proptosis or exophthalmos. Exophthalmos is usually used when describing bulging eyes caused by Graves disease, a disorder causing overactivity… read more ), double vision, and vision loss are also possible. Symptoms related to IgG4-related orbital inflammation, on the other hand, are usually minimal. Rarely is there any discomfort, but rather proptosis and eyelid swelling Eyelid Swelling A person may experience swelling in one or both eyelids. Swelling may be painless or accompanied by itching or pain. Eyelid swelling is distinct from bulging eyes, although a few disorders can… read more are common. Other symptoms depend upon the disorder causing the orbital inflammation.

Computed tomography Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) A variety of tests can be done to confirm an eye problem or to determine the extent or severity of an eye disorder. Each eye is tested separately. In general, angiography involves injecting… read more (CT) or magnetic resonance imaging Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) A variety of tests can be done to confirm an eye problem or to determine the extent or severity of an eye disorder. Each eye is tested separately. In general, angiography involves injecting… read more (MRI) is done. A doctor may do other blood tests and take a sample from the inflamed area for examination under a microscope (biopsy) to determine the cause.

Many disorders causing inflammation of the orbit are treated with a corticosteroid drug, which can be given by mouth. Corticosteroids can be given by vein (intravenously) if the inflammation is severe. Radiation therapy or drugs and treatments that change the body’s immune responses may sometimes be used. IgG4 typically responds to corticosteroids or, if necessary, other drugs to change the body’s immune response (for example, rituximab).

Sometimes surgery is needed to help resolve or prevent progression of thyroid eye disease.

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Periostitis of the eye orbit symptoms and treatment in Moscow Make an appointment. Treatment at home and in the clinic – Clinic SINAI near the metro station Dobryninskaya, Serpukhovskaya in Moscow

Periostitis is a process that has an inflammatory nature that occurs in the periosteum (connective tissue located on all surfaces outside the bone). Inflammation most often begins in the outer or inner layers of this tissue, then the process penetrates into its remaining layers. Due to the fact that the periosteum and bone are practically one whole, the inflammatory process also begins in the bone tissue, it is called osteoperiostitis.

The disease may develop quite rapidly over two to three days or gradually over a couple of weeks. Gradually, the inflammation resolves and is replaced by connective tissue. The catarrhal process can turn into a purulent one, while a subperiosteal abscess develops, threatening to turn into a phlegmon of the orbit.

The form of the disease called posterior periostitis is rather difficult to diagnose. The patient with it is concerned about pain in the orbit, decreased visual acuity, reduced skin sensitivity on the eyelids, limited movement of the eyeballs and conjunctival chemosis.

If periostitis has developed as a result of tuberculosis or syphilis, then it is characterized by an anterior location. The tuberculous type of the disease manifests itself in the lower outer part of the orbit, proceeds painlessly. The syphilitic form of the disease is accompanied by severe pain at night.

Classification

Localization distinguishes between anterior and posterior periostitis of the ocular orbit, by the nature of the process there is a simple and purulent type of disease.

Downtime often develops against the background of infectious diseases (for example, measles, syphilis, rubella, tuberculosis, etc. ). The increase in symptoms with it is slow, characterized by edema, pain in the eyelids and the edges of the orbit, hyperemia. With properly selected therapy, a complete cure is possible with a slight thickening in the area of ​​\u200b\u200binflammation.

The purulent form of the disease begins rapidly, accompanied by malaise, headaches, high fever, local symptoms are much stronger than with simple periostitis. The patient needs hospitalization.

In anterior periostitis, inflammation is localized along the edge of the eye orbit, an infiltrate is formed, and a fistula may occur on the skin. This form of the disease is treated surgically.

In case of posterior periostitis, the infiltrate accumulates in the region of the ethmoid bone, the main sinus. May be complicated by optic neuritis with decreased function.

Also, periostitis can be acute and chronic. The first is accompanied by purulent inflammatory processes, occurs due to the penetration of pathogenic microorganisms into the periosteum. The development of the disease can be suspected by the appearance of swelling on the periosteum and swelling of the soft tissues. Further, the swelling is transformed into purulent inflammation, the patient’s body temperature rises to 38-39 degrees.

The chronic form of the disease is accompanied by the appearance of a thickening on the bone, it does not cause pain. This form of the disease is detected during an x-ray examination, the lesion has a clear outline. With it, pathological changes in the bone tissue of moderate severity, severe hyperplasia in the periosteum are observed. The chronic form develops if the acute form has not been cured. In some cases, periostitis of the eye orbit does not go through an acute stage, but immediately begins with a sluggish, chronic one.

Reasons for the development of the disease

The following reasons can cause periostitis:

1. The introduction of pathogenic microbes (Koch’s bacillus, spirochete, streptococcus, staphylococcus) into the body.

2. Angina.

3. Sinusitis.

4. Scarlet fever.

5. Furunculosis.

6. Injuries to the eyes and face, in which wounds form.

7. Dacryocystitis.

8. Purulent inflammation of the conjunctiva or cornea.

9. Influenza.

10. Caries or periodontal disease.

11. Sinusitis.

Pathogenesis of the disease

The mechanism of the appearance and course of the disease is divided into types:

1. Traumatic. The disease occurs as a consequence of trauma that affects the periosteum. There is an inflammatory process of an aseptic nature. The disease can manifest itself in an acute form, but if left untreated, it becomes chronic. It is treated with the use of physiotherapy, applications, magnets to reduce the amount of exudate. Next, laser therapy is applied to reduce the thickening on the periosteum.

2. Toxic. It occurs due to the impact on the periosteum in the region of the eye orbit of various toxins that enter there with blood or lymph from other affected areas. This type often develops against the background of general diseases of the body.

3. Inflammatory. The disease develops due to inflammation of nearby tissues.

4. Allergic. It occurs due to an allergic reaction of the body to any irritating factors.

5. Specific. It develops against the background of certain diseases.

Diagnosis

Periostitis of the ocular orbit requires careful diagnosis. The patient should consult an ophthalmologist and an otorhinolaryngologist. Most often, doctors prescribe the following diagnostic methods:

1. General and biochemical blood tests.

2. Radiography of the eye orbit.

3. Examination of the sinuses.

4. Enzyme immunoassay for the detection of antibodies of pyogenic bacteria.

5. Computed or magnetic resonance imaging.

Differential diagnosis

These diagnostic methods are used if a person has symptoms of several similar diseases. They help to make an accurate diagnosis. For example, to distinguish acute and purulent periostitis from abscess, phlegmon, lymphadenitis and other ailments. Chronic, aseptic and specific periostitis are detected using X-ray examination, they allow to identify thickenings, growths on the bones, necrotic tissue changes, etc.

If an x-ray does not allow an accurate diagnosis, then doctors resort to a biopsy.

Periostitis in children

According to the nature of the course, periostitis in children can have acute and chronic forms. Although the first type of disease is more common. The disease can occur against the background of an injury and due to infection in the periosteum.

Methods of treatment

Drug therapy

Periostitis of the eye orbit is treated in a complex way. The doctor may prescribe the following antibacterial medicines for the treatment of a simple non-suppurative type of disease:

• Nitrofural;

• Tobrex;

• Cyloxane;

• Floxal;

• Erythromycin;

• Uniflox;

• Tetracycline.

Antiseptic drugs are also prescribed:

• Hydrogen peroxide;

• Methenamine.

Reparative drugs:

• Korneregel;

• Methyluracil.

The purulent form of the disease is treated in a hospital, since it is necessary to open the infiltrate. Posterior periostitis is also treated in the hospital, since treatment should be systemic and include antibiotic therapy, vitamin preparations, sulfanilamide, detoxification, antihistamines, decongestants. If neighboring sinuses are involved in the inflammatory process, then an autopsy is also necessary.

Periostitis of the ocular orbit, accompanied by complications of a purulent or septic nature, is always treated with antibiotics. It is worth noting that the drug should be prescribed by a doctor after all tests have been carried out, since some bacteria such as staphylococcus and streptococcus have mutated over time and gained resistance to certain types of antibacterial drugs. Staphylococci are not sensitive to penicillin antibiotics, and streptococci still die from them. The disease can be caused not by one specific bacterium, but by their association, for example, staphylococcus + streptococcus, staphylococcus + Pseudomonas aeruginosa + Proteus, etc.

Not so long ago, periostitis of the ocular orbit was treated with loading doses of antibiotics, but today this method of treating the disease is a thing of the past. A large amount of an antibacterial drug can cause intoxication of the body, provoke the development of allergic reactions, candidiasis or dysbacteriosis.

To cure the purulent form of periostitis, the doctor prescribes antibiotics that have a tropism for bone tissue. Suitable for this purpose:

Antibacterial drugs should be taken for at least 7 days. If the disease requires longer treatment with antibiotics, then the doctor prescribes new ones every 7-10 days so that harmful microorganisms cannot develop resistance to them. Also, the medication is changed if the patient has complications of the disease. With long-term treatment with drugs of this type, the patient needs to donate blood for analysis weekly.

Purulent form of periostitis of the ocular orbit is treated in a complex way, therefore antibiotics are often combined with antifungal medications. Which include:

• Nystatin;

• Levorin;

• Griseofulvin.

If the doctor believes that the disease is caused by anaerobic microbes, he prescribes the following medicines to the patient:

• Ampicillin;

• Celaforidin;

• Carbenicillin.

Anaerobic infections are best treated with antibiotics belonging to the cephalosporin group:

• Ceftriaxone;

• Trichopolum;

• Metronidazole.

Also, for the treatment of periostitis caused by these types of pathogenic microorganisms, drugs such as Biseptol and Dioxidin can be prescribed.

Physiotherapy

After the patient undergoes drug therapy to eliminate inflammation, he is prescribed physiotherapy:

1. Laser treatment.

2. Magnetotherapy.

3. Ultrasound.

4. Infrared irradiation.

5. UHF therapy.

6. Inductothermy.

7. UV exposure.

Physiotherapy is needed in order to eliminate pain, accelerate tissue regeneration and metabolic processes in them, improve local immunity, normalize blood circulation and lymph flow, relieve swelling, have anti-inflammatory and bactericidal effects.

Treatment of periostitis in children

In childhood, the disease can be both endogenous and post-traumatic. In children, due to their anatomical features of the body, the disease develops rapidly, begins with local signs of inflammation, fever. Other signs of the disease are manifested in the form of asymmetric edema from the affected area, soft tissue edema, swollen lymph nodes. If the child is not shown to the doctor in time and adequate treatment is not started, then the disease can become chronic.

In children, the treatment of periostitis of the eye orbit begins with the removal of the focus of infection. Next, the doctor prescribes antibiotics, for example, Amosiklav, Metronidazole, drugs such as Nurofen and Diphenhydramine. In addition, with complex treatment, vitamins are prescribed, for example, “Multitabs”. With a purulent form of the disease, surgical intervention is required, washing the affected area with antiseptic agents and drainage.

Treatment of the disease at home

Only a doctor can decide whether periostitis of the eye orbit can be treated at home. At home, you can only carry out those procedures that reduce pain. It is better not to postpone a visit to the hospital. In some cases, a non-purulent or simple type of disease can be treated at home, but exactly following all the requirements and instructions of the attending physician. As a rule, such therapy consists in anesthetizing the affected area, taking non-steroidal anti-inflammatory drugs, the doctor also prescribes a scheme for their use. It is not recommended to apply compresses on your own and drink tinctures from medicinal herbs.

Prognosis of periostitis

The prognosis of a cure for a disease largely depends on its form and the timeliness of the treatment started. If therapy began to be carried out on time, and the disease, for example, developed as a result of an injury, then, as a rule, it is treated quite successfully.

Purulent advanced forms of periostitis of the ocular orbit may indicate an unfavorable prognosis for the course of the disease. Complications can arise here, inflammation can spread to neighboring tissues, and sepsis can occur.

Periostitis resulting from any disease often becomes chronic. The success of their cure depends on how successfully the underlying ailment is cured.

Doctors note that periostitis is a rather insidious disease that leads to serious consequences for the human body and its skeletal system. At the slightest suspicion of its development, you must go to the hospital.

Osteomyelitis – health articles

11/10/2022

Osteomyelitis is a purulent infection that affects the bone tissue (osteitis), the periosteum surrounding the bone (periostitis), and the bone marrow (myelitis). Osteomyelitis that occurs for the first time is called acute. In the case of a long course of the disease with periods of exacerbation and remission, they speak of the development of chronic osteomyelitis.

Causes

Osteomyelitis develops as a result of bacteria entering the bone tissue, periosteum or bone marrow. Infection of the bone can occur in an endogenous (internal) way, such osteomyelitis is usually called hematogenous.

Purulent inflammation of the bones can occur with the penetration of microorganisms from the environment – this is exogenous osteomyelitis.

Symptoms

The clinical picture is usually characterized by a hyperacute onset of the disease with septic, toxic symptoms. The temperature is high, in older children, osteomyelitis begins with chills; the pulse is rapid, the child is very lethargic and gives the impression of being seriously ill. In the early days, local symptoms of osteomyelitis are sometimes not expressed, a severe general condition completely determines the clinical picture. The patient usually complains of bone pain; the pain intensifies, the affected bone becomes sensitive to pressure. Local redness and swelling are not early symptoms of osteomyelitis, but after 2-3 days from the onset, when a subperiosteal abscess occurs, these signs are striking.

When an abscess ruptures under the periosteum, the pain decreases and redness, swelling, and fluctuation are revealed.

Diagnosis

In addition to the assessment of clinical manifestations and manual examination, laboratory methods are used. A general blood test with a leukocyte formula in expanded form shows a shift to the left. This means that the inflammation in the body is caused by a bacterial nature.

Along with laboratory methods, instrumental examination methods are used:

• Radiography is the most common way to diagnose osteomyelitis. Using images, you can determine the localization of necrotic processes, the volume and severity of the infectious focus. With the help of x-rays, the disease can be detected in the early stages. As the inflammation grows, the nature of the image in the pictures changes, so the time of the course of the disease can be indicated with high accuracy.
• Computed tomography is the most informative way to diagnose osteomyelitis in any of its manifestations. With the help of volumetric images, it is possible to obtain not only data on the localization and intensity of the infection, but also to create a reconstruction of the surrounding muscle tissues and predict the course of the disease.

For an accurate diagnosis, which is of decisive importance in the treatment of osteomyelitis, a combination of laboratory and instrumental methods of research is necessary.

Treatment

Treatment of acute osteomyelitis is carried out only in a hospital. Massive antibiotic therapy is carried out taking into account the sensitivity of microorganisms. A prerequisite for the successful treatment of acute osteomyelitis is the drainage of a purulent focus. In the early stages, trepanation holes are made in the bone, followed by washing with solutions of antibiotics and proteolytic enzymes.
In purulent arthritis, repeated punctures of the joint are performed to remove pus and administer antibiotics; in some cases, arthrotomy is indicated. When the process spreads to soft tissues, the resulting abscesses are opened, followed by open washing.

In the treatment of chronic osteomyelitis, surgery is indicated in the presence of osteomyelitic cavities and ulcers, purulent fistulas, sequesters, false joints, frequent relapses with intoxication, severe pain and impaired function of the limb, malignancy, impaired activity of other organs and systems due to chronic purulent infection.