Abstract
Bone and joint infections gather heterogeneous clinical situations according to numerous factors (infected site, presence of orthopedic device, infection chronicity, etc.). They occur because of traumatic inoculation, hematogenous seeding, or contiguous spread. The presence of foreign material such as implanted devices or dead bone significantly reduces the number of organisms required to cause infections and allows normal skin commensals to become significant pathogens. These infections have a dynamic environment comprised of different bone matrix qualities and cell types, in addition to the potential presence of biofilms or prostheses. Their pathophysiology implicates complex interactions between the infectious agent, host immune system, and osteoarticular tissue. It involves virulence factors at the initial phase of tissue invasion and destruction and persistence mechanisms leading to chronicity and relapse. Recent advances in experimental and clinical studies have significantly improved the understanding of bone and joint pathophysiology, which is a key factor for development of more effective diagnostic and therapeutic strategies through joint efforts of clinicians, scientists, and engineers.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Romanò CL, Romanò D, Logoluso N, Drago L. Bone and joint infections in adults: a comprehensive classification proposal. Eur Orthop Traumatol. 2011;1(6):207–17.
Oliveira TC, Gomes MS, Gomes AC. The crossroads between infection and bone loss. Microorganisms. 2020;8(11):1765.
Cordero-Ampuero J, de Dios M. What are the risk factors for infection in hemiarthroplasties and total hip arthroplasties? Clin Orthop. 2010;468(12):3268–77.
Gutierrez K. Bone and joint infections in children. Pediatr Clin North Am. 2005;52(3):779–94, vi.
Zimmerli W, Ochsner PE. Management of infection associated with prosthetic joints. Infection. 2003;31(2):99–108.
Jamard S, Ferry T, Valour F. Physiopathologie des infections ostéoarticulaires. Rev Rhum Monogr. 2022;89(1):3–10.
Ghislain Aubin G, Corvec S. Épidémiologie et physiopathologie générale des infections ostéo-articulaires. Rev Francoph Lab. 2016;2016(480):25–31.
Ader F, Salomon J, Perronne C, Bernard L. Origine de l’infection osseuse: endogène ou exogène? Éléments de physiopathologie. Méd Mal Infect. 2004;34(11):530–7.
Dessì A, Crisafulli M, Accossu S, Setzu V, Fanos V. Osteo-articular infections in newborns: diagnosis and treatment. J Chemother Florence Italy. 2008;20(5):542–50.
Momodu II, Savaliya V. Septic arthritis. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2023. [Cited 2023 Jul 13]. http://www.ncbi.nlm.nih.gov/books/NBK538176/.
He M, Vithran DTA, Pan L, Zeng H, Yang G, Bangbao L, et al. An update on recent progress of the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis: a review. Front Cell Infect Microbiol [Internet]. 2023;13:1193645. [Cited 2023 Jul 13]. https://pubmed.ncbi.nlm.nih.gov/37249986/.
Ross JJ. Septic arthritis of native joints. Infect Dis Clin North Am. 2017;31(2):203–18.
Roerdink RL, Huijbregts HJTAM, van Lieshout AWT, Dietvorst M, van der Zwaard BC. The difference between native septic arthritis and prosthetic joint infections: a review of literature. J Orthop Surg Hong Kong. 2019;27(2):2309499019860468.
Ateschrang A, Albrecht D, Schroeter S, Weise K, Dolderer J. Current concepts review: septic arthritis of the knee pathophysiology, diagnostics, and therapy. Wien Klin Wochenschr. 2011;123(7–8):191–7.
Couderc M, Bart G, Coiffier G, Godot S, Seror R, Ziza JM, et al. 2020 French recommendations on the management of septic arthritis in an adult native joint. Joint Bone Spine. 2020;87(6):538–47.
Lew DP, Waldvogel FA. Osteomyelitis. Lancet Lond Engl. 2004;364(9431):369–79.
Schmitt SK. Osteomyelitis. Infect Dis Clin North Am. 2017;31(2):325–38.
Rosenberg AE, Khurana JS. Osteomyelitis and osteonecrosis. Diagn Histopathol. 2016;22(10):355–68.
Desimpel J, Posadzy M, Vanhoenacker F. The many faces of osteomyelitis: a pictorial review. J Belg Soc Radiol. 2017;101(1):24.
Yang J, Yao JL, Wu ZQ, Zeng DL, Zheng LY, Chen D, et al. Current opinions on the mechanism, classification, imaging diagnosis and treatment of post-traumatic osteomyelitis. Chin J Traumatol. 2021;24(6):320–7.
DeSanto J, Ross JS. Spine infection/inflammation. Radiol Clin North Am. 2011;49(1):105–27.
Cottle L, Riordan T. Infectious spondylodiscitis. J Infect. 2008;56(6):401–12.
Tsantes AG, Papadopoulos DV, Vrioni G, Sioutis S, Sapkas G, Benzakour A, et al. Spinal infections: an update. Microorganisms. 2020;8(4):476.
Giurato L, Meloni M, Izzo V, Uccioli L. Osteomyelitis in diabetic foot: a comprehensive overview. World J Diabetes. 2017;8(4):135–42.
Noor S, Khan RU, Ahmad J. Understanding diabetic foot infection and its management. Diabetes Metab Syndr. 2017;11(2):149–56.
Malhotra R, Chan CSY, Nather A. Osteomyelitis in the diabetic foot. Diabet Foot Ankle. 2014;5
Murphy-Lavoie HM, Ramsey A, Nguyen M, Singh S. Diabetic foot infections. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2023. [Cited 2023 Jul 13]. http://www.ncbi.nlm.nih.gov/books/NBK441914/.
Bernard L. Mécanismes physiopathologiques des infections sur matériel orthopédique. Rev Rhum. 2006;73(4):327–31.
Archibeck MJ, Jacobs JJ, Roebuck KA, Glant TT. The basic science of periprosthetic osteolysis. Instr Course Lect. 2001;50:185–95.
Zimmerli W, Waldvogel FA, Vaudaux P, Nydegger UE. Pathogenesis of foreign body infection: description and characteristics of an animal model. J Infect Dis. 1982;146(4):487–97.
Bernard L, Vaudaux P, Merle C, Stern R, Huggler E, Lew D, et al. The inhibition of neutrophil antibacterial activity by ultra-high molecular weight polyethylene particles. Biomaterials. 2005;26(27):5552–7.
Vergara-Irigaray M, Valle J, Merino N, Latasa C, García B, Ruiz de los Mozos I, et al. Relevant role of fibronectin-binding proteins in Staphylococcus aureus biofilm-associated foreign-body infections. Infect Immun. 2009;77(9):3978–91.
Fischer B, Vaudaux P, Magnin M, el Mestikawy Y, Proctor RA, Lew DP, et al. Novel animal model for studying the molecular mechanisms of bacterial adhesion to bone-implanted metallic devices: role of fibronectin in Staphylococcus aureus adhesion. J Orthop Res. 1996;14(6):914–20.
Paharik AE, Horswill AR. The Staphylococcal biofilm: adhesins, regulation, and host response. Microbiol Spectr. 2016;4(2).
Arciola CR, Campoccia D, Montanaro L. Implant infections: adhesion, biofilm formation and immune evasion. Nat Rev Microbiol. 2018;16(7):397–409.
Rasigade JP, Trouillet-Assant S, Laurent F. Infections ostéo-articulaires à staphylocoques. Rev Francoph Lab. 2016;2016(480):33–40.
Veerachamy S, Yarlagadda T, Manivasagam G, Yarlagadda PK. Bacterial adherence and biofilm formation on medical implants: a review. Proc Inst Mech Eng H. 2014;228(10):1083–99.
Masters EA, Trombetta RP, de Mesy Bentley KL, Boyce BF, Gill AL, Gill SR, et al. Evolving concepts in bone infection: redefining ‘biofilm’, ‘acute vs. chronic osteomyelitis’, ‘the immune proteome’ and ‘local antibiotic therapy’. Bone Res. 2019;7:20.
Achour W, Chebbi Y. Pathophysiology of tuberculosis and microbiological diagnosis. In: Ladeb MF, Peh WCG, editors. Imaging of tuberculosis [Internet]. Cham: Springer International Publishing; 2022. p. 15–27. https://doi.org/10.1007/978-3-031-07040-2_2. [Cited 2023 Aug 2]. (Medical Radiology).
Chelli Bouaziz M, Ladeb MF, Labbène E, Riahi H, Achour W, Berriche A, et al. Imaging of spinal tuberculosis. In: Ladeb MF, Peh WCG, editors. Imaging of spinal infection [Internet]. Cham: Springer International Publishing; 2021. p. 211–35. https://doi.org/10.1007/978-3-030-70459-9_12. [Cited 2023 Aug 2]. (Medical Radiology).
Hogan JI, Hurtado RM, Nelson SB. Mycobacterial musculoskeletal infections. Infect Dis Clin. 2017;31(2):369–82.
Gardam M, Lim S. Mycobacterial osteomyelitis and arthritis. Infect Dis Clin North Am. 2005;19(4):819–30.
Martini M, editor. Tuberculosis of the bones and joints [Internet]. Berlin, Heidelberg: Springer; 1988. [Cited 2023 Jul 10]. http://link.springer.com/10.1007/978-3-642-61358-6.
Masson E. Brucellose [Internet]. EM-Consulte. [Cited 2023 Jul 11]. https://www.em-consulte.com/article/1109511/brucellose.
Maurin M. La brucellose à l’aube du 21e siècle. Méd Mal Infect. 2005;35(1):6–16.
Michaux-Charachon S, Foulongne V, O’Callaghan D, Ramuz M. [Brucella at the dawn of the third milenium: genomic organization and pathogenesis]. Pathol Biol (Paris). 2002;50(6):401–12.
Ebrahimpour S, Bayani M, Moulana Z, Hasanjani Roushan MR. Skeletal complications of brucellosis: a study of 464 cases in Babol. Iran Casp J Intern Med. 2017;8(1):44–8.
Gür A, Geyik MF, Dikici B, Nas K, Cevik R, Sarac J, et al. Complications of brucellosis in different age groups: a study of 283 cases in southeastern Anatolia of Turkey. Yonsei Med J. 2003;44(1):33–44.
Chelli Bouaziz M, Ladeb MF, Riahi H, Achour W, Berriche A, Ammari L, et al. Imaging of spinal brucellosis. In: Ladeb MF, Peh WCG, editors. Imaging of spinal infection [Internet]. Cham: Springer International Publishing; 2021. p. 183–97. https://doi.org/10.1007/978-3-030-70459-9_10. [Cited 2023 Aug 2]. (Medical Radiology).
Belhaj Salah N, Kooli I, Ben Azaiez M, Marrakchi W, Ben Brahim H, Toumi A, et al. La brucellose ostéoarticulaire. Rev Rhum. 2020;87:A225.
Masson E. Manifestations ostéoarticulaires de la brucellose [Internet]. EM-Consulte. [Cited 2023 Jul 11]. https://www.em-consulte.com/article/8233/manifestations-osteoarticulaires-de-la-brucellose.
Chakroun M, Bouzouaia N. La brucellose: une zoonose toujours d’actualité. Rev Tun Infectiol. 2007;1(2):1–10.
Henry MW, Miller AO, Walsh TJ, Brause BD. Fungal musculoskeletal infections. Infect Dis Clin North Am. 2017;31(2):353–68.
Bariteau JT, Waryasz GR, McDonnell M, Fischer SA, Hayda RA, Born CT. Fungal osteomyelitis and septic arthritis. J Am Acad Orthop Surg. 2014;22(6):390–401.
Arkun R, Mete BD. Musculoskeletal hydatid disease. Semin Musculoskelet Radiol. 2011;15(5):527–40.
Ladeb MF, Riahi H, Mechri M, Chelli Bouaziz M, Trabelsi S, Rammeh S. Imaging of spinal hydatidosis. In: Ladeb MF, Peh WCG, editors. Imaging of spinal infection [Internet]. Cham: Springer International Publishing; 2021. p. 237–50. https://doi.org/10.1007/978-3-030-70459-9_13. [Cited 2023 Aug 2]. (Medical Radiology).
Masters EA, Ricciardi BF, de Mesy Bentley KL, Moriarty TF, Schwarz EM, Muthukrishnan G. Skeletal infections: microbial pathogenesis, immunity and clinical management. Nat Rev Microbiol. 2022;20(7):385–400.
Hofstee MI, Muthukrishnan G, Atkins GJ, Riool M, Thompson K, Morgenstern M, et al. Current concepts of osteomyelitis: from pathologic mechanisms to advanced research methods. Am J Pathol. 2020;190(6):1151–63.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Frigui, S., Chebbi, Y., Achour, W. (2024). Pathophysiology of Bone and Joint Infections. In: Rammeh Rommani, S., Ladeb, M.F. (eds) Histopathology of Bone and Joint Infections. Springer, Cham. https://doi.org/10.1007/978-3-031-54888-8_1
Download citation
DOI: https://doi.org/10.1007/978-3-031-54888-8_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-54887-1
Online ISBN: 978-3-031-54888-8
eBook Packages: MedicineMedicine (R0)