Learning Radiology xray montage

Osteomyelitis of the Skull

  • Two modes of spread

    • Direct extension from paranasal sinuses

    • Retrograde septic thrombophlebitis

  • Epidural extension separates the dura from the inner table of skull

    • Removes major blood supply to the inner table of skull

    • Predisposes bone to widespread infection

    • Sutures tend to arrest progress for some time

  • Dura is resistant to infection at first

    • Then yields to meningitis and abscess

  • X-ray- findings become evident 7-10 days after infection starts

    • Early

      • Islands of normal bone

      • Increased or diminished density

    • Advanced

      • Lytic process

  • Frontal sinus is most commonly involved

  • Brain abscess is most common complication