Wednesday, March 18, 2009

Acute Osteomyelitis

Answers to ANR, hope this will help, insyaAllah.

Ada 2 types of OM :
1) hematogenous OM
2) contiguous focus OM
Bone kanak-kanak

So, in this case, i'll explain about hematogenous OM.

Acute OM

  • accounts for 20% of cases
  • primarily affects children (long bones are affected), older adults and IV drug users (spine - most common site of infection)
  • acute hematogenous OM VS Vertebral OM
Acute Hematogenous OM
  • usually involve single bone, most commonly tibia, femur, or humerus in children
  • on presentation : acutely ill, high fever, chills, localized pain & tenderness, restriction of movement, cutaneous erythema and swelling
  • history of recent blunt trauma to the area involved should be obtained, this event will result in small intraosseous hematoma or vascular obstruction & route of entry of microorganisms through wounds
  • plain radiograph shows : periosteal reaction (seen in 10days after onset of infection), soft tissue swelling, lytic changes (after 2-6 weeks), Brodie's abscess (rare)
  • 90% of cases of acute OM is caused by Staphylococcus aureus
  • Treatment : Cloxacillin

Brodie's abscess - a chronic abscess of bone surrounded by dense fibrous tissue and sclerotic bone

Sequestrum - a fragment of dead bone separated from healthy bone as a result of injury or disease

Involucrum - a covering of new bone around a sequestrum

Ok, rasanya takat tu je kot..kalau ade pape salah bg tau ye...

"Living well or living hell, fighting for the future!!!" =P


`Aainaa Nur Raihana Abdullah on March 18, 2009 at 1:56 AM said...

hasil penerangan dr tok guru:

infection > inflammation > release cytokines > PMN infiltration > increase intraosseus pressure > pain.

the increment in intraosseus pressure > occlude blood vessel > necrosis of bone > known as sequestrum > this will then be surrounded by new bone formed by the deep periosteum layer > known as involucrum.

terima kasih kpd tok guru yg telah bekerja keras memahamkan diri yg lemah ini.

`Aainaa Nur Raihana Abdullah on March 18, 2009 at 2:01 AM said...

trima kasih diucapkan kepada ibnu shaukani.
bak kata lukachikuto, sharing is charity.

lukachikuto, kalo nak request, jgn malu2. dengan adanya admin yg baik hati, Insya Allah, anda x akan dihampakan :P


Ibnu Shaukani on March 18, 2009 at 6:58 AM said...

ena rai, yes, gud explanation.

lukachikuto tu simpan bakat terpendam. nanti sampai satu masa, aku melimpah2 ilmu die kt sini

cuma, perlu tunggu masa untuk diletupkan.hoho~ ke nak guna c4? =P

ainaa ismail on March 21, 2009 at 12:51 PM said...

pertanyaan sebentar
2nd picture showspus discharge
the question is pus discharge bukn dlm chroic ke?
in acute bukan ada involucrum ke,new bone formation covering the sequestrum itu?

ainaa ismail on March 21, 2009 at 12:53 PM said...

i mean pus discharge sampai nmmppk kat skin.

Ibnu Shaukani on March 21, 2009 at 5:36 PM said...

ena, aku tak pasti. tp yg dlm pbl week 3 musculo tu, die jd chronic sebab duration die 6 months and sebab die dpt antibiotics yang tak betul (dpt ampicillin instead of cloxacillin)

ni ade note sket pasal chronic OM.

Chronic Osteomyelitis

•More likely to develop in contiguous-focus than in hematogenous osteomyelitis
•Sinus tract between bone and skin may drain purulent material and occasionally pieces of necrotic bone
•An increase in drainage, pain, or ESR signals an exacerbation
•Fever is unusual except when obstruction of a sinus tract leads to soft tissue infection
•Rare late complications :
oPathologic fractures
oSquamous cell carcinoma of the sinus tract


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