Osteomyelitis: Difference between revisions

Revision as of 06:09, 27 September 2011

Infection of the bone by bacteria or fungus
Etiology
- Contiguous spread (80%)
- Hematogenous spread (20%)
  - More common in peds (long bones)
  - Less common in adults (spine)

Diabetic pts with one or more of the following:
- Skin ulceration >2cm
- Positive probe-to-bone test
- ESR >70 (83-92% Sn)
- Abnormal x-ray

Pain at the site
- May also have warmth, swelling, erythema
X-ray
- May be normal early in the course
- Later will show bone demineralization, periosteal elevation, lytic lesions
Blood culture
Bone scan

Tintinalli

Authors:

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 ==Background==
-*usu hematogenous spread starting @ metaphysis b/c wbc cannot exit there, minor trauma= osteo in rabbits post staph inj(x)
+*Infection of the bone by bacteria or fungus
-*age >2, immunecompetent Rx for staph strep, only need bone if <2 b/c other causes ie e. coli
+*Etiology
+**Contiguous spread (80%)
+**Hematogenous spread (20%)
+***More common in peds (long bones)
+***Less common in adults (spine)
+==Risk Factors==
+*Diabetic pts with one or more of the following:
+**Skin ulceration >2cm
+**Positive probe-to-bone test
+**ESR >70 (83-92% Sn)
+**Abnormal x-ray
 ==Diagnosis==
-*usu rubor, dolor etc at about 3-5 days, no xr changes until 10 days
+*Pain at the site
+**May also have warmth, swelling, erythema
+*X-ray
+**May be normal early in the course
+**Later will show bone demineralization, periosteal elevation, lytic lesions
+*Blood culture
+*Bone scan
-*Bcx alone= org 50% of time, w/ bone & bcx get 70% of org!
+==Treatment==
-*Order xr, cbc, crp, bcx,
+==Source==
+Tintinalli
-==Treatment==
-ancef or ox
 [[Category:Peds]]
 [[Category:Ortho]]