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Возбудители чаще всего — бактерии, преимущественно золотистый стафилококк, реже — стрептококки, грамотрицательные бактерии или микобактерии туберкулёза [1](https://doct.ru/diseases/osteomiyelit.html). \n\nЗаболевание может развиваться как остро, так и принимать хроническую форму с периодами ремиссии и обострений [1](https://doct.ru/diseases/osteomiyelit.html).\n\n\n\n## Причины\nОстеомиелит развивается, когда инфекция проникает в костную ткань [1](https://doct.ru/diseases/osteomiyelit.html). Некоторые пути заражения: \n* **Гематогенный** — инфекция попадает в кость с током крови из другого воспалительного очага (например, при фурункулёзе, тонзиллите, кариесе) [1](https://doct.ru/diseases/osteomiyelit.html). \n* **Посттравматический** — после серьёзных травм, особенно при открытых переломах челюсти или длинных трубчатых костей [1](https://doct.ru/diseases/osteomiyelit.html). Нарушение кожного покрова даёт инфекции прямой доступ к кости [1](https://doct.ru/diseases/osteomiyelit.html). \n* **Контактный** — распространение инфекции с рядом расположенных мягких тканей (например, при абсцессах, глубоких пролежнях) [1](https://doct.ru/diseases/osteomiyelit.html). \n* **Послеоперационный** — возможен после операций на костях, особенно при использовании имплантов или остеосинтеза, если нарушены условия стерильности или у пациента ослаблен иммунитет [1](https://doct.ru/diseases/osteomiyelit.html).\n\n## Симптомы\nКлинические проявления зависят от формы заболевания, возраста пациента, локализации процесса и его обширности [1](https://doct.ru/diseases/osteomiyelit.html). Некоторые общие симптомы: \n* сильная, пульсирующая боль в поражённой кости, усиливающаяся при движении [1](https://doct.ru/diseases/osteomiyelit.html); \n* высокая температура (до 39–40 °C), озноб, потливость [1](https://doct.ru/diseases/osteomiyelit.html); \n* выраженная слабость, потеря аппетита, интоксикация [1](https://doct.ru/diseases/osteomiyelit.html); \n* отёк и покраснение кожи над областью воспаления [1](https://doct.ru/diseases/osteomiyelit.html); \n* ограничение подвижности в ближайшем суставе или поражённой конечности [1](https://doct.ru/diseases/osteomiyelit.html); \n* в запущенных случаях — появление свищевых ходов и истечение гноя наружу (формирование гнойных свищей) [1](https://doct.ru/diseases/osteomiyelit.html). \n\nВ хроническом остеомиелите симптомы могут быть менее выраженными, с периодическими обострениями и формированием свищей или деформацией кости [1](https://doct.ru/diseases/osteomiyelit.html).\n\n## Диагностика\nДиагностика остеомиелита требует комплексного подхода с использованием клинических, лабораторных и инструментальных методов [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). Некоторые методы: \n* **Рентгенография костей** — информативна на поздних стадиях, на снимках выявляются зоны остеолиза, остеосклероза, секвестры, деформация костных структур [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). \n* **Компьютерная томография** — более точно визуализирует кости, свищевые ходы, наличие инородных тел [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). \n* **Магнитно-резонансная томография** — выявляет ранние воспалительные изменения в костном мозге и мягких тканях, особенно полезна при поражении позвоночника и таза [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). \n* **Ультразвуковое исследование** — помогает обнаружить скопления жидкости, инфильтраты, сформировавшиеся абсцессы [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/).\n\n## Лечение\nЛечение остеомиелита должно быть комплексным, включающим антибактериальную терапию, хирургическую санацию очага, дренирование, иммобилизацию и реабилитационные мероприятия [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). Некоторые методы: \n* **Антибиотики** — подбираются с учётом чувствительности возбудителя [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). \n* **Хирургическое вмешательство** — направлено на удаление некротических тканей, секвестров, санацию абсцессов, удаление свищевых ходов, восстановление анатомической целостности кости [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). \n* **Иммобилизация поражённой конечности** — осуществляется с помощью гипсовых лонгет, ортезов, аппаратов внешней фиксации [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). \n* **Физиотерапия** — включает УВЧ, магнитотерапию, лазерное воздействие, электрофорез с антибиотиками, озонотерапию [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/). \n* **После купирования острого процесса** — важна реабилитация: лечебная физкультура, массаж, восстановление объёма движений, профилактика контрактур и атрофии мышц [12](https://premium-clinic.ru/osteomielit-simptomy-prichiny-i-lechenie-infektsionnogo-porazheniya-kostey/).","linksData":[{"sourceId":1,"url":"https://doct.ru/diseases/osteomiyelit.html","shownUrl":"https://doct.ru/diseases/osteomiyelit.html","title":"Остеомиелит - 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