osteitis

Osteitis is inflammation of bone tissue. It can be acute or chronic and may affect a single bone or multiple sites. The term covers a spectrum of conditions in which bone is inflamed, including noninfectious inflammatory bone diseases and infection-related inflammation. The term "osteitis" is often considered in contrast to osteomyelitis, which denotes a bone infection with pus formation, though infection can trigger osteitic inflammation.

Common examples include alveolar osteitis, also known as dry socket, a localized inflammatory condition of the alveolar bone after tooth extraction; chronic nonbacterial osteitis (CRMO), a pediatric autoinflammatory disorder; osteitis fibrosa cystica, a bone-change pattern seen in prolonged hyperparathyroidism; and the historical term osteitis deformans, linked to Paget disease of bone.

Diagnosis rests on clinical evaluation supported by imaging and laboratory studies. Patients may have focal bone pain and tenderness; fever or systemic symptoms suggest infection. Plain radiographs, CT, or MRI can reveal areas of inflammation, sclerosis, or lucency. Elevated inflammatory markers (CRP, ESR) are common; blood cultures and bone biopsy help distinguish infectious from noninfectious etiologies when needed.

Treatment targets the underlying cause. Noninfectious inflammatory osteitis is usually managed with nonsteroidal antiinflammatory drugs, and in refractory cases with corticosteroids or disease-modifying agents. Infectious osteitis requires appropriate antimicrobial therapy and source control. In dental alveolar osteitis, management includes analgesia, antiseptic rinses, and avoidance of disturbing the socket; underlying metabolic disorders are treated specifically (eg, hyperparathyroidism). The prognosis varies with cause and disease extent, with CRMO often relapsing and dental osteitis typically resolving in days to weeks.