Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


Relapse may take place within a few months of the original attack, or
not for many years. Cases are sometimes met with in which relapses recur
at regular intervals for several years, the tendency, however, being for
the attacks to become milder as the virulence of the organisms becomes
more and more attenuated.


_Clinical Features._--Osteomyelitis in a patient over twenty-five is
nearly always of the relapsing variety. In some cases the bone becomes
enlarged, with pain and tenderness on pressure; in others there are the
usual phenomena which attend suppuration, but the pus is slow in coming
to the surface, and the constitutional symptoms are slight. The pus may
escape by new channels, or one of the old sinuses may re-open.
Radiograms usually furnish useful information as to the condition of the
bone, both as it is altered by the original attack and by the changes
that attend the relapse of the infective process.

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