Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


It may be instructive to describe _the X-ray appearances of a long bone
that has passed through an attack of acute osteomyelitis_ severe enough
to have caused necrosis of part of the diaphysis. The shadow of the dead
bone is seen in the position of the original shaft which it represents;
it is of the same shape and density as the original shaft, while its
margins present an irregular contour from the erosion concerned in its
separation. The sequestrum is separated from the living bone by a clear
zone which corresponds to the layer of granulations lining the cavity in
which it lies. This clear zone separating the shadow of the dead bone
from that of the living bone by which it is surrounded is conclusive
evidence of a sequestrum. The medullary canal in the vicinity of the
sequestrum being obliterated, is represented by a shadow of varying
density, continuous with that of the surrounding bone. The shadow of the
new case or involucrum with its wavy contour is also in evidence, with
its openings or cloacae, and is mainly responsible for the increase in
the diameter of the bone.

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