Edit concept Question Editor Create issue ticket

Osteomyelitis of the Tibia

Osteomyelitis of Tibia


Presentation

  • Longitudinal stress fracture of the tibia often present with an atypical clinical presentation which can be mistaken for osseous tumor or osteomyelitis.[ncbi.nlm.nih.gov]
  • We present a case of brucella osteomyelitis of the proximal tibia that demonstrates these features.[ncbi.nlm.nih.gov]
  • Two patients presented with recurrence of infection within the period of follow-up. Mean follow-up period was 23 months. All donor sites were skin grafted primarily, with 95%-100% graft take.[ncbi.nlm.nih.gov]
  • This article presents the case of a patient with chronic osteomyelitis of the tibia, who had no complication after débridement, intramedullary reaming and pulse lavage without tourniquet but sustained a compartment syndrome 2 weeks later during a second[ncbi.nlm.nih.gov]
  • We present the case of an adult male with PVL toxin-producing methicillin-sensitive S. aureus (MSSA) osteomyelitis of the tibia which has not previously been described in adults and highlight issues of recognition, treatment, and surgical management of[ncbi.nlm.nih.gov]
Fever
  • Symptoms of bone infections include Pain in the infected area Chills and fever Swelling, warmth, and redness A blood test or imaging test such as an x-ray can tell if you have a bone infection. Treatment includes antibiotics and often surgery.[icdlist.com]
  • Despite the resolution of fever and pains, purulent discharge was noticed from the leg. This continued until bone started protruding from the discharge point.[ajmhs.org]
  • In spite of intravenous antibiotics for 48 hours, she continued to have fever and repeat CT showed recollection of abscess in left upper tibia for which repeat CT-guided aspiration and pigtail catheter insertion was done.[saudijhealthsci.org]
  • Early symptoms of what used to be called “bone fever” are fever and bone pain (as one might assume), as well as local warmth and swelling, and an overall malaise.[academia.dk]
  • Nor was it possible to eliminate the pain or fever which impeded him from walking.[medbc.com]
Recurrent Infection
  • Two cases required repeated debridement before grafting due to recurrent infection. One patient had a small bone diameter due to insufficient grafting, and one patient had limitation of knee activity.[ncbi.nlm.nih.gov]
  • At a mean follow-up of 21 months (8 to 36), 23 patients (96%) had no evidence of recurrent infection.[ncbi.nlm.nih.gov]
  • People usually take them for 4 to 6 weeks, except for recurrent infections or infections of the spinal vertebrae, which need a 6- to 8-week treatment. For serious infections, the buildup of pus may need to be drained by surgery.[medbroadcast.com]
  • The diagnosis of CO is usually fairly obvious with a prior history of recurrent infections, disability and deformity arising after an initial event.[ptolemy.ca]
Asymptomatic
  • Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasing in prevalence among asymptomatic carriers and in cases of paediatric soft-tissue infections alike.[ncbi.nlm.nih.gov]
  • MRI is the diagnostic study of choice with respect to both sensitivity and specificity because it can define early radiographically negative AVN in asymptomatic individuals. [7], [8] There are few reports in the medical literature describing osteomyelitis[saudijhealthsci.org]
  • The patient has subsequently been followed up for 2 years and has remained asymptomatic ( Figure 6B ).[woundsresearch.com]
  • The latter two are most commonly used to rule out other diseases and to detect asymptomatic sites employing whole body screening techniques. 1, 4 - 6, 12 Long and tubular bones are preferentially affected, especially the lower limbs. 1, 4 - 6 In a study[scielo.br]
  • The lesion is usually asymptomatic with no accompanying general and local signs of inflammation, although the clinical picture may vary widely.[jisppd.com]
Plethora
  • A plethora of alternative therapies have evolved. Hyperbaric oxygen has been proven to enhance bone and soft tissue healing in many in vitro and in vivo studies.[ncbi.nlm.nih.gov]
Aspiration
  • Because of the concern for septic arthritis, each patient underwent knee aspiration as part of the evaluation.All recovered with conventional infection treatment protocols.[ncbi.nlm.nih.gov]
  • Surgery included débridement, implant removal, and reaming of the medullary canal with a new device that allows reaming under simultaneous irrigation and aspiration.[ncbi.nlm.nih.gov]
  • We report a prospective case series using an intramedullary reaming device, the Reamer-Irrigator-Aspirator (RIA) system, in association with antibiotic cement rods for the treatment of lower limb long bone infections.[ncbi.nlm.nih.gov]
  • In spite of intravenous antibiotics for 48 hours, she continued to have fever and repeat CT showed recollection of abscess in left upper tibia for which repeat CT-guided aspiration and pigtail catheter insertion was done.[saudijhealthsci.org]
  • Gram stain may be positive in 30% of aspirates, but only culture is definitive.[ptolemy.ca]
Petechiae
  • ITP occurs in 1.0-12.5 per 100,000 per year. [1] The clinical manifestations of thrombocytopenia include purpura, petechiae and bruising.[saudijhealthsci.org]
Bone Pain
  • Bone lesion biopsy (Medical Encyclopedia) Bone pain or tenderness (Medical Encyclopedia) Disseminated tuberculosis (Medical Encyclopedia) Osteomyelitis (Medical Encyclopedia) Osteomyelitis - children (Medical Encyclopedia) Osteomyelitis - discharge (Medical[icdlist.com]
  • Before this, patient had a high grade fever associated with severe bone pain, listlessness, and inability to play with his mates for several weeks. His symptoms improved with drugs bought from the patented medicine dealers.[ajmhs.org]
  • Chronic osteomyelitis causes intermittent (months to many years) bone pain, tenderness, and draining sinuses.[merckmanuals.com]
  • Symptoms include fever, chills, and bone pain; later, swelling and redness may develop around the area of infection. Diagnosis is confirmed by radionuclide bone scans.[britannica.com]
  • Early symptoms of what used to be called “bone fever” are fever and bone pain (as one might assume), as well as local warmth and swelling, and an overall malaise.[academia.dk]
Knee Pain
  • Her knee pain too, did not abate. The diagnosis only became obvious after this patient underwent magnetic resonance imaging (MRI) 10 days after initial onset of knee pain.[ispub.com]
Medial Tibial Stress Syndrome
  • Medial tibial stress syndrome and chronic osteomyelitis are conditions that are traditionally thought to affect very different patient groups.[ncbi.nlm.nih.gov]
Epistaxis
  • Figure 3: MRI both leg showing features of osteomyelitis in both proximal tibiae Click here to view She continued to have spontaneous haemorrhages in the form of epistaxis and haematuria.[saudijhealthsci.org]
Excitement
  • Dear Reader, We are very excited about New Features in JOCR. Please do let us know what you think by Clicking on the Sliding “Feedback Form” button on the[jocr.co.in]
Neglect
  • The aim of this report is to highlight this unusual condition and the need for continued health education as well as for the clinician not to despair in the management of similar neglected cases in a resource-poor setting.[ajmhs.org]

Workup

  • Preoperative planning The Cierny-Mader classification system (see Workup ) plays an important role in guiding treatment.[emedicine.medscape.com]

Treatment

  • Successful treatment was achieved in 13 patients (86%). The mean length of treatment was 45 days. The preliminary results are comparable with other series.[ncbi.nlm.nih.gov]
  • BACKGROUND: Chronic hematogenous osteomyelitis often results from the improper treatment of acute hematogenous osteomyelitis. At present, there is lack of uniform standards for the treatment, and the clinical features of the disease are unclear.[ncbi.nlm.nih.gov]
  • It usually heals after treatment with debridement, antibiotics, and/or pin removal, only rarely developing into delayed osteomyelitis.[ncbi.nlm.nih.gov]
  • Abstract The authors comment on the experience acquired in the treatment of chronic osteomyelitis of the long bones with intramedullary reaming.[ncbi.nlm.nih.gov]
  • BACKGROUND: The treatment of posttraumatic osteomyelitis of the tibia requires meticulous debridement and adequate soft tissue coverage.[ncbi.nlm.nih.gov]

Prognosis

  • Staged techniques could decrease the number of complications and improve the functional prognosis of the limbs [ 3 ]. References Motta H (2002) Technique fibula pro tibia nonunion of the tibia.[omicsonline.org]
  • What is the prognosis for osteomyelitis? With early diagnosis and appropriate treatment, the prognosis for osteomyelitis is good.[medicinenet.com]
  • Malnutrition and low immune status are risk factors in the pathogenesis of osteomyelitis. [2] Malnutrition worsens the prognosis and grade of the chronic osteomyelitis. [2] These risk factors pervade in a situation of ignorance and poverty like in our[ajmhs.org]
  • […] negative / equivocal in 70% ACUTE OSTEOMYELITIS IN INFANCY Age Pathomechanism Spread to epiphysis through blood vessels Marked soft-tissue component Subperiosteal abscess with extensive periosteal new bone formation Complications Frequent joint involvement Prognosis[learningradiology.com]
  • […] 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]

Etiology

  • […] the underlying etiology.[icd10data.com]
  • Many patients will have a history positive for a recent respiratory tract infection or otitis media (most cases of osteomyelitis in the pediatric population have a hematogenous etiology).[med-ed.virginia.edu]
  • The etiology of this disease has still not been fully clarified.[ncbi.nlm.nih.gov]
  • Characters four through six of the code identify etiology, anatomic site, severity, and other details, Gold says. For example, coders will find the following codes in the M86- series.[hcpro.com]
  • The main treatment goal for Garre's osteomyelitis is to eliminate the etiologic factor, most frequently by extraction of the causative tooth.[jisppd.com]

Epidemiology

  • Epidemiology of acute hematogenous osteomyelitis in children: a prospective study over a 32 month period. Europe PMC 2012;90:473-8. 4. Kanakaris N, Gudipati S, Tosounidis T, Harwood P, Britten S, Giannoudis PV.[ajmhs.org]
  • The changing epidemiology of acute and subacute haematogenous osteomyelitis in children. Journal of Bone & Joint Surgery - British Volume 2001; 83(1):99-102. (340 kb) Steer AC, Carapetis JR.[ptolemy.ca]
  • This small series, together with a review of the literature, enabled us to describe the principle epidemiological and diagnostic features, focusing on early signs.[em-consulte.com]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • - biofilm : - aggregation of microbe colonies with in extracellular polysaccharide matrix (glycocalyx) which is adherent to surface of metal implants or devitalized bone; - references: - Pathophysiology of Infections After Internal Fixation of Fractures[wheelessonline.com]
  • The pathophysiology of post-trauma osteomyelitis shares some but not all of these characteristics. ( 9 ) The growth and development of long bones from the epiphyseal plate also determines the characteristics of bony infection.[ptolemy.ca]

Prevention

  • 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]
  • Prompt surgical treatment weighed against the risk of bleeding, in such immunocompromised thrombocytopenic patient, can prevent progression to chronic osteomyelitis. References 1. Michel M, Chanet V, Galicier L, Ruivard M, Levy Y, Hermine O, et al.[saudijhealthsci.org]
  • Can Osteomyelitis Be Prevented? One way to prevent osteomyelitis is to keep skin clean. All cuts and wounds — especially deep wounds — should be cleaned well.[kidshealth.org]
  • We prevented iatrogenic fracture by gentle curettage and by applying protective cast in addition to avoiding weight bearing some weeks after the operation.[ajmhs.org]
  • Prevention Patients with a weakened immune system should: Cleaning and dressing an open wound can prevent infection.[medicalnewstoday.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!