Haematogenious and traumatic osteomyelitis. Diagnosis and treatment. Flashcards
what is osteomyelitis ?
inflammation of the bone or bone marrow
hematogenous osteomyelitis is caused by what ?
bacteremia - by contaminated needle usage
hemodialysisi
or dental extraction
higher risk in = immunosuppressed patient
spread into bone cortex and periosteum by the haversian canals
whee does osteomyelitis usually occur ?
in older - usually the vertebrae
in children - the metaphysic of long bones
traumatic osteomyelitis is caused by what ?
open fractures where the bone is exposed to outside environment
what is the reposes to osteomyelitis from the body ?
acute osteomyelitis comes to evolution if the lesion is not extensive and there is viable bone - the osteoblasts and osteoclasts repair the damage over periods of weeks
chronic osteomyelitis
affected bone can become necrotic and separates from the healthy bone no connection to the aversion system or osteons
which is called a sequesterum
and there can be periosteal reaction around he sequester called the involcrum
what is the complication of osteomyelitis ?
can affect the nearby joint and overlying skin and blood vessels - thrombophlebitis
which is the most common organism causing osteomyelitis
staph aureus most common
patients with sickle cell anemia - due to salmonella
pseudomonas - intravenous drug users
what are the signs andsymtpoms of osteomyelitis
localised pain in bone
and fever
diagnosis of osteomyelitis
blood count
x ray - can show thickening of cortical bone and peroisostem
osteopenia loss of bone mass
foal bone lysis
bone scan or MRI confirm the presence of osteomyelitis
bone biopsy
treatment
surgery to drain the abcess and remove any necrotic
stabilise the bone with external fixations
fill in the cavity with bone chips or cement
bone - antibiotics will not reach sequester because its avascular
give intravenous antibiotic treatment
dd of osteomyelitis ?
can be confused with benign or malignant tumor
