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Progression of bacterial osteomyelitis. (a) Pathogens colonize the cortical bone, forming an abscess. (b) The forming abscess increases in size and is surrounded by new bone formation, causing the elevation of the periosteum. (c) The localized infection constricts the vascularization leading to the necrosis of the bone, forming the sequestrum. The sequestrum is surrounded by new bone where a sinus tract will be formed, allowing the drainage of the pus.
