1.

Osteomielitis Akut

The first x-ray, 2 days after symptoms began, is normal –

it always is; metaphyseal mottling and periosteal changes
were not obvious until the second film, taken 14 days later;
eventually much of the shaft was involved.
Destruksi cortex

o Initial radiographs often normal for as long as 7-10 days

o Localized soft-tissue swelling adjacent to metaphysis with obliteration
of usual fat planes (after 3-10 days)
o Area of bone destruction (lags 7-14 days behind pathologic changes)
Destruksi Cortex dan Periosteal reaction

Bone destruksi dan periosteal reaction

The earliest changes are seen in adjacent soft tissues +/- muscle outlines with swelling and loss or blurring
of normal fat planes. An effusion may be seen in an adjacent joint.

In general, osteomyelitis must extend at least 1 cm and compromise 30 to 50% of bone mineral content to
produce noticeable changes on plain radiographs. Early findings may be subtle, and changes may not be
obvious until 5 to 7 days from onset in children and 10 to 14 days in adults. On radiographs taken after this
time period, a number of changes may be noted:

2. Osteomielitis Subakut
 Abses Brodie

3. Osteomielitis Kronik
Pemeriksaan rongent memperlihatkan gambaran sekuester dan penulangan baru
(involukrum), cloacha.
 Perkembangan involukrum

Involukrum
In chronic or untreated cases, eventual formation of a sequestrum, involucrum and/or cloaca may be seen.

 Involucrum = cloak of laminated /spiculated periosteal reaction

(develops after 20 days)
 Sequestrum = detached necrotic cortical bone (develops after 30 days)
 Cloaca formation = space in which dead bone resides