ABFAS Boards – Rearfoot and Forefoot Practice Test

Chronic osteomyelitis is a long-standing bone infection that tends to smolder rather than cause an acute, systems-toxic illness. The most characteristic clinical picture is a draining sinus tract that persists over time, reflecting ongoing infection. This is usually accompanied by chronic bone changes on imaging, such as periosteal reaction and formation of new bone around the area (involucrum), and sometimes dead bone trapped inside (sequestrum). Because the process is chronic, high fevers and systemic toxicity are less common than in the acute form. It can affect adults as well as children, so it isn’t limited to pediatric patients. Sequestrum formation is a known feature, but the persistent draining sinus with chronic changes best captures the typical presentation of chronic osteomyelitis.