Presentation
Most of the patients presented with swelling, pain and discharging sinus. [ncbi.nlm.nih.gov]
Osteomyelitis of the scapula usually presents as an acute event [ 4 ]. Koubaa et al. demonstrated a mean presentation within 48 hrs. [omicsonline.org]
Characteristics/Clinical Presentation Individuals presenting with osteomyelitis may have the following symptoms [5] : Pain and/or tenderness in the infected area Inflammation, redness, and warmth in the infected area Fever, chills, and excessive sweating [physio-pedia.com]
Acute osteomyelitis Acute Osteomyelitis presents with an acute pyrexia illness. The child is toxic and ill and complains of bone pain. [www0.sun.ac.za]
Most patients with vertebral osteomyelitis present with localized pain and tenderness of the involved vertebrae with a slow progression over 3 weeks to 3 months. Fever may be present in approximately 50% of patients. [emedicine.medscape.com]
Entire Body System
- Fever
" or "shin bone fever" -Often caused by body lice; think homeless [quizlet.com]
For this reason, it is very important to seek medical attention whenever the bone pain worsens and presents itself along with fever. [ic.steadyhealth.com]
In adults, back pain is typically the chief complaint but once the infection becomes systemic, a low-grade fever may be present. [physio-pedia.com]
Systemic signs, such as fever and chills, are more indicative of an acute infection. Diagnosis of clinically suspected cases is supported via laboratory tests, biopsy, and/or imaging. [amboss.com]
- Anemia
Certain conditions increase the risk of developing such an infection, including sickle cell anemia, injury, the presence of a foreign body (such as a bullet or a screw placed to hold together a broken bone), intravenous drug use (such as heroin), diabetes [medical-dictionary.thefreedictionary.com]
The most common organisms involved in osteomyelitis in children with sickle cell anemia include Salmonella species, S aureus, Serratia species, and Proteus mirabilis . [emedicine.medscape.com]
Differential Diagnoses Acute Rheumatic Fever Ewing’s Tumor Acute Suppurative Arthritis Laboratory Studies A complete blood count is useful for evaluating leukocytosis and anemia. [boneandspine.com]
[…] influenzae, and Enterobacter species Children, adolescents (aged 4 y to adult) S. aureus (80%), group A Streptococcus species, H. influenzae, and Enterobacter species Adult S. aureus and occasionally Enterobacter or Streptococcus species Sickle cell anemia [en.wikipedia.org]
- Malaise
Patient may be extremely irritable or lethargic, and complain about general discomfort, uneasiness or malaise. [ic.steadyhealth.com]
[…] features Acute osteomyelitis Onset : usually gradual, over several days Chief complaint : pain at the site of infection, possibly related to movement Possible localized findings : point tenderness, swelling, redness, warmth Possible systemic findings : malaise [amboss.com]
Fever and malaise/ pain and local tenderness / Swelling/ compartment syndrome has been reported in children. · WBC count often normal, · ESR and CRP level elevated. · The CRP is a measurement of the acute phase response and is especially useful in monitoring [orthopaedicsmadeeasy.blogspot.com]
Initially there may be several days of fever and a generalized feeling of ill health (malaise). [rarediseases.org]
Patient systemically unwell with fever and malaise. Joint symptoms often variable with diurnal variation and by definition, last > 6 weeks. May be normal acute phase reactants (ESR and CRP) and white cell count. [pmmonline.org]
- Collapse
[…] this region Prevertebral abscess formation in the cervical spine can be life threatening → risk of tracheal compression and airway obstruction Symptoms: neck pain, difficulty swallowing, difficulty breathing, and possible respiratory failure Vertebral collapse [amboss.com]
[…] weeks and spinal immobilization; in a few cases, surgical management may be indicated in case of absence of clinical improvement after 2–3 weeks of intravenous antibiotics, presence of persistent pain, development of biomechanical instability, vertebral collapse [jcvjs.com]
In fact, one fourth of all persons with Lupus develop progressive musculoskeletal damage in the form of arthritis, osteoporosis with fracture and vertebral collapse, and osteomyelitis [7]. Medications (Table courtesy of American Family Physician. [physio-pedia.com]
The L2–L3 disk is collapsed. F, Axial T1-weighted (500/18/1.5) spin-echo image at the L3 level depicts epidural and paraspinal inflammation ( arrows ). [ajnr.org]
No removal of sequestrum was advised during this stage to avoid damage and collapse of the periosteal tube. During the chronic stage, sequestrum was removed through cloaca or small window in the bone. [jpgmonline.com]
- Weight Loss
In addition, she reported a 30-pound weight loss over the preceding 4 months. [ajnr.org]
Musculoskeletal
- Bone Pain
For this reason, it is very important to seek medical attention whenever the bone pain worsens and presents itself along with fever. [ic.steadyhealth.com]
This may be followed by an increase in fever (104-105 degrees Fahrenheit), deep localized bone pain, chills, sweating, swelling and painful or limited movement of the nearby joints. [rarediseases.org]
The child is toxic and ill and complains of bone pain. In South Africa osteitis is common, and must be suspected in any child who presents with a painful limb together with a pyrexia illness. [www0.sun.ac.za]
When to see a doctor See your doctor if you experience worsening bone pain along with fever. [mayoclinic.org]
The infection usually affects the long bones of the upper and lower limbs and causes acute pain and fever. It most often occurs in children and adolescents. Onset may be sudden, with chills, high fever, and severe pain. [medical-dictionary.thefreedictionary.com]
- Joint Stiffness
Characteristics include red or dark patches on the skin; burning, itching, swelling, hardening, and tightening of the skin; yellow spots on the whites of the eyes; joint stiffness with trouble moving or straightening the arms, hands, legs, or feet; pain [emedicine.medscape.com]
- Bone Disorder
Diagnosis Symptoms of osteomyelitis can resemble those of many other bone disorders. Bone scans, blood tests bone biopsies are tests that help diagnose this disorder so that treatment can be started immediately. [rarediseases.org]
- Joint Deformity
Old joint affection, epiphyseal damage and deformities would require salvation by definite planned proceures. [jpgmonline.com]
- Arthralgia
Early disseminated - weeks after infection with neurological features (facial nerve palsy, meningitis and rarely meningoencephalitis), heart conduction defects and arthralgia. [pmmonline.org]
Workup
Routine laboratory workup revealed that the erythrocyte sedimentation rate was 56 mm in the first hour. Hemoglobin level was 9.8 g/dL. The full blood count showed normocytic normochromic anemia, and a normal total and differential white cell count. [bone.imedpub.com]
Microbiology
- Neisseria Gonorrhoeae
Gonorrhoea Principles of management of septic arthritis and osteomyelitis Prompt diagnosis, urgent washout and drainage of joint and rapid treatment with antibiotics. [pmmonline.org]
Osteomyelitis has also been due to other bacterial infections flamely Neisseria gonorrhoea 18, Bacillus 19, Serratia, Marcescens 9,20 Enterobacter aerogenese 21, Rhodococcus 22, and Pseudomonas 23, while other workers have isolated Hemophillus influen [jpma.org.pk]
Laboratory
- Leukocytosis
[…] the distal femur and proximal tibia ) Clinical features : frequently asymptomatic or only mild symptoms; pain Treatment : surgical drainage References: [3] [10] Diagnostics Clinical approach Laboratory tests Inflammatory markers ↑ CRP, ↑ ESR Possible leukocytosis [amboss.com]
Laboratory studies may reveal peripheral leukocytosis and an elevated erythrocyte sedimentation rate (ESR). [emedicine.medscape.com]
Differential Diagnoses Acute Rheumatic Fever Ewing’s Tumor Acute Suppurative Arthritis Laboratory Studies A complete blood count is useful for evaluating leukocytosis and anemia. [boneandspine.com]
Leukocytosis and elevations in the erythrocyte sedimentation rate and C-reactive protein level may be noted. Blood cultures are positive in up to one half of children with acute osteomyelitis. [aafp.org]
Treatment
Control 163 5 Vaccines 164 6 Political Issues 165 7 Ethics 166 References 167 RSV and Influenza Treatment and Prevention 169 14 Surfactant 170 17 Antiviral Treatment 171 22 Amantadine 172 25 Cold Adapted Influenza Vaccine CAIV 173 References 174 EncephalitisBeyond [books.google.de]
Treatment of chronic osteomyelitis using antibiotic-impregnated bone cement beads or nail after thorough debridement has become a good option of treatment. [jemds.com]
There are two approaches to treatment, with either curative or palliative intent; surgery is now the most important treatment modality in both. [aerzteblatt.de]
Prognosis
This part addresses treatment, where there have been numerous new contributions in recent years, 1–10 as well as follow-up and prognosis. [analesdepediatria.org]
[…] surgical debridement of necrotic bone, weakened host defenses May develop sinus tract lined by squamous epithelium that forms large epidermal inclusion cyst within bone; rarely transforms to well differentiated squamous cell carcinoma with excellent prognosis [pathologyoutlines.com]
Prognosis Prognosis varies depending on how quickly an infection is identified, and what other underlying conditions exist to complicate the infection. [medical-dictionary.thefreedictionary.com]
Etiology
[…] the underlying etiology. [icd10data.com]
It is concluded that antibiotics selected according to the etiological setting can be initiated without the need to start empirical antibiotics. [search.bvsalud.org]
Etiology, demography, risk factors, and management in 35 cases. Oral Surg Oral Med Oral Pathol 1992 ; 74 : 149 –54 6 Yeoh, SC, MacMohan, S, Schifter, M. Chronic suppurative osteomyelitis of the mandible: case report. [doi.org]
The etiology and pathogenesis are mostly in the form of odontogenic infections allowing deep tissue penetration and proliferation of oral pathogens and hence establishment of a bone infection. [infona.pl]
Epidemiology
153 7 Conclusion 154 Congenital Cytomegalovirus Infection Epidemiology and Treatment 155 13 Maternal Age 156 2 Therapeutic Interventions 157 3 Summary 158 References 159 Global Control of Rotavirus Disease 161 3 Epidemiology 162 4 Approaches to Disease [books.google.de]
[…] osteomyelitis : more common in adults References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Epidemiology 1 to 2.4 cases per 100,000 people ( Zimmerli 2010 ) More common in males with M:F of 3:1 Rate is also increasing due to increased number of spinal procedures Typically affects adults, with most cases occurring in patients over 50 years old [coreem.net]
The changing epidemiology of osteomyelitis in children. J Bone Joint Surg 1992;74B(4):541-545 ↑ Zimmerli W. Vertebral osteomyelitis. N Engl J Med 2010;362:1022-1029. ↑ Boeglin ER. [physio-pedia.com]
Introduction Overview Infection of bone characterized by progressive inflammatory destruction and apposition of new bone treatment is often a combination of culture-directed antibiotics and surgical debridement of nonviable tissue Epidemiology incidence [orthobullets.com]
Pathophysiology
References: [4] Subtypes and variants Definition : osteomyelitis of the vertebrae Pathophysiology : hematogenous seeding of a distant infectious focus → infection of the vertebral bone → contiguous spread to the intervertebral discs (and adjacent vertebrae [amboss.com]
Brodie abscess : Small intraosseous abscess in cortex, walled off by reactive bone with no periosteal reaction Cavity may contain infectious organisms or be sterile May have late recrudescence Therapy: total surgical excision ( Tunis Med 2007;85:857 ) Pathophysiology [pathologyoutlines.com]
We discuss biofilm formation as a clinically relevant pathophysiological model and present current recommendations for the treatment of osteomyelitis. [aerzteblatt.de]
The pathophysiology of osteomyelitis is complex and poorly understood. [physio-pedia.com]
[…] lateral clavicle in IV drug abusers foot and decubitus ulcers in diabetics risk factors recent trauma or surgery immunocompromised patients illicit IV drug use poor vascular supply systemic conditions such as diabetes and sickle cell peripheral neuropathy Pathophysiology [orthobullets.com]
Prevention
221 3 Vaccine Formulation 222 4 Immunological Memory 224 5 Carriage 225 7 Immunologies Issues in PracticeThe UK Experience 226 8 Conclusion 228 Strategies for Preventing Group B Streptococcal Disease 231 3 Tackling GBS Disease 232 4 Treatment or Prevention [books.google.de]
Osteomyelitis surgery prevents the infection from spreading further or getting so bad that amputation is the only remaining option. Preventing Osteomyelitis The best way to prevent osteomyelitis is to keep things clean. [webmd.com]
Saucerization was avoided to prevent permanent weakening of the bone (See [Figure - 1] ). [jpgmonline.com]
Type I= polymicrobial Type II= linked to S. pyogenes Catalase - (determining separator from Staph); B hemolytic; bacitracin sensitive ; often called Group A S (GAS) S. pyogenes virulence factors •ScpC (SpyCEP) cell envelope protease cleaves IL8 and prevents [quizlet.com]
Prevention is another area in cases of osteomyelitis where physical therapists can play an important role. [physio-pedia.com]