The studied material of scanning and transmission electron microscopy were bone fragments of 40 patients obtained during surgery from various pathologically altered sections of the affected tubular bones. Morphological studies revealed microscopic foci of necrosis, leukocyte infiltrates and microabscesses both in the main focus and in other parts of the bone marrow canal. Microabscesses detected by microscopy represent the morphological basis of chronic hematogenous osteomyelitis, can be located at a considerable distance from the main necrotic purulent focus and, under appropriate conditions, cause a relapse of the disease. Morphological studies have shown that surgical debridement of the lesion with ultrasonic cavitation of the lesion and the medullary canal contributes to a significant reduction in the degree of microbial contamination, followed by a decrease in pathological changes in bone tissue.

Our aim is to evaluate the possibilities and effectiveness of computed tomography (CT) in a complex of the examination of patients with chronic recurrent hematogenic osteomyelitis of tubular bones. The effectiveness of the CT use in a complex of examination of 60 chronic recurrent hematogenous osteomyelitis of tubular bones in patients aged from 7 to 22 years was analyzed in the work. CT, in contrast to the survey X-ray, made it possible to more accurately determine the true dimensions of the destructive process in the affected bone. In all cases, CT surpassed traditional radiography in the identifying small sequesters promoting chronic inflammation and causing a persistently recurrent course of the disease. With the help of CT, delineated foci of destruction, i.e., intraosseous abscesses, were clearly visualized, whereas with the plain X-ray this substrate was not detected. The obtained data show the high resolution of the CT, to provide with complete information on pathomorphological changes in the bone. This seems extremely important for planning treatment tactics and choosing the amount of surgical intervention.