1 / 28

Osteomyelitis

Osteomyelitis is an infection of the bone and bone marrow that can occur in acute, subacute, or chronic forms. This condition has various classifications based on the method of occurrence, such as hematogenous and direct transmission. Multiple systemic and local factors can predispose individuals to osteomyelitis, including diabetes, malnutrition, and immune suppression. Diagnosis involves imaging techniques while treatment may include antibiotics and surgery based on the severity and underlying conditions. Awareness of symptoms and timely intervention is crucial for effective management.

mmcnaughton
Télécharger la présentation

Osteomyelitis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Osteomyelitis Reşat ÖZARAS, MD, Prof. Infection Dept. rozaras@yahoo.com

  2. OSTEOMYELITIS • Infection of bone marrow and and adjacent bone Several classifications

  3. The duration of the disease • Acute osteomyelitis • Subacute osteomyelitis • Chronic osteomyelitis

  4. The way of occurence 1 - Hematogenous osteomyelitis 2 – Osteomyelitis secondary to direct transmission - Any vascular disease may/not associate 3 - Chronic osteomyelitis (necrotic bone)

  5. Anatomical classification • Stage 1: medullary osteomyelitis • Stage 2: superficial osteomyelitis • Stage 3: localized osteomyelitis • Stage 4: diffuse osteomyelitis

  6. SYSTEMICAND LOCAL FACTORS Systemic Local MalnutritionChronic lymphedema Renal, hepatic failure Venous failure Diabetes mellitus Vascular insufficiency Chronic hipoxia Arteritis Alcohol and/or tobacco use Tissue scar Malignant disordersRadiation fibrosis Advanced age Neuropathy Immune suppression HIV/AIDS

  7. ETIOLOGY • Babies (<1 year) • Group B streptococci • S. aureus • E. coli • Children(1 - 16 years) • S. aureus • S. pyogenes • H. influenzae • Adult(> 16 years) • S. epidermidis • S. aureus • P. aeruginosa

  8. EPIDEMIOLOGY • Acute hematogenous osteomyelitis: a disorder of childhood period • A trend to increase: traffic accidents, increasing rates of orthopedic interventions. • Adults– Vertebtal osteomyelitis (Spondylodiscitis)

  9. CLINICAL FEATURES AcuteHematogenousOsteomyelitis - Systemicdisorder - No structural bone changes - A history of lessthan 10 days - No previousepisodes SubacuteHemotogenousOsteomyelitis -Systemicdisorder (not as severe as theacute form) -Bone changes -A history of morethan 10 days - No previousepisodes Chronicosteomyelitis -Systemicdisordermay/not associate -Bone changes -There is/arepreviousepisode(s).

  10. Clinical Features • Depends on the way of development (hematogenous, direct, from adjacent tissues), patient's characteristics and the period of the disorder • Hematogenous osteomyelitis • fever, fatigue, restlessness • Tenderness, pain, and edema on the affected site • Decreased mobility of the affected extremity • Muscle spasms

  11. From adjacent tissue; pain, redness, swellings, a draining sinus from the site of trauma, wound, or operation • Dorsal/back pain in vertebral osteomyelitis .

  12. RADIOLOGICAL FINDINGS Plain X-ray; • Diagnosis and the course of the disease • Increase in density of the surrounding soft tissues (first 10 days) • Periostal reaction (after 10 days) • Bone loss in subacute period

  13. Bone scan • For early diagnosis

  14. Computed tomography Sentitive for soft tissue inflammation as well. Diagnosis and follow-up of the therapy

  15. Magnetic Resonance • Soft tissue and bone marrow inflammation • Early diagnosis

  16. Differential Diagnosis • Rheumatic fever • Cellulitis • Ewing’s sacroma • Septic arthritis • Osteosarcoma • Eosinophilic granuloma • Thrombophlebitis

  17. Vertebral Osteomyelitis • Frequent etiology: • S. aureus, • M. tuberculosis, • Brucella • Gram-negative bacilli (Gastrointestinal or urinary system) • Postoperative • Pain and disability • May be indolent and fever may not be seen

  18. Tx • Antibiotics • Surgery • Underlying disorder

  19. Antibiotics Meticilin-sensitive Staph. → Cefazolin or Sulbactam/ampicillin Meticilin-resistant Staph →Vancomycin or teicoplanin Brucella → Rifampin+doxycycline Tuberculosis → INH+RIF+PZA+EMB

  20. Etiology

  21. Pyogenic

  22. Children: Acute hematogenous Adult: Chronic (hematogenous---from adjacent tissues…

More Related