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[44] firstdeveloped a model of osteomyelitis resembling human disease in rabbit tibiae using SM asa sclerosing agent, although radiographic signs due to infection were difficult to distinguishfrom radiographic signs due to the sclerosing agent The principle of combining inoculationwith local ischemia was developed further, using lower doses of SM, which sustainedchronic osteomyelitis over longer periods [46] and has subsequently been replicated in ratsand goats [47, 48].

Data fromthe Dutch CRANS study, which randomly recruited35- to 60-year-old subjects in Amsterdam, reported alifetime incidence of 35%; importantly, the peak age ofincidence was 15 years.

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