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Osteomyelitis: Difference between revisions
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<section begin="orthopaedics chronic" /><section begin="radiology" />'''Osteomyelitis''' is an infection involving bone, caused by bacteria in most cases. It may be severe, and it may affect any bone. The pathogen may enter the bone directly (non-hematogenous osteomyelitis), usually after trauma or wounds, or from the blood (haematogenous osteomyelitis).<section end="radiology" /><section end="orthopaedics chronic" /> | <section end="orthopaedics acute" /><section begin="orthopaedics chronic" /><section begin="radiology" />'''Osteomyelitis''' is an infection involving bone, caused by bacteria in most cases. It may be severe, and it may affect any bone. The pathogen may enter the bone directly (non-hematogenous osteomyelitis), usually after trauma or wounds, or from the blood (haematogenous osteomyelitis).<section end="radiology" /><section end="orthopaedics chronic" /> | ||
Acute osteomyelitis develops within days or weeks. It's most common in children < 5 years, where haematogenous spreading of [[S. aureus]] is the most common cause. It also occurs in adults, where direct spread from a trauma, ulcer, or from haematogenous spreading after IV drug use is the most common cause.<section begin="orthopaedics chronic" /> | Acute osteomyelitis develops within days or weeks. It's most common in children < 5 years, where haematogenous spreading of [[S. aureus]] is the most common cause. It also occurs in adults, where direct spread from a trauma, ulcer, or from haematogenous spreading after IV drug use is the most common cause.<section end="orthopaedics acute" /><section begin="orthopaedics chronic" /> | ||
Chronic osteomyelitis is a form of osteomyelitis that develops insidiously over months or years. It's usually related to bone ischemia or necrosis, due to how ischaemic or necrotic bone is not reached by antibiotics and the immune system, proving grounds for a chronic infection. Chronic osteomyelitis results in bone destruction and sequestrum formation. It's difficult to treat and it often recurs. In adults, chronic osteomyelitis is a common complication of acute osteomyelitis. | Chronic osteomyelitis is a form of osteomyelitis that develops insidiously over months or years. It's usually related to bone ischemia or necrosis, due to how ischaemic or necrotic bone is not reached by antibiotics and the immune system, proving grounds for a chronic infection. Chronic osteomyelitis results in bone destruction and sequestrum formation. It's difficult to treat and it often recurs. In adults, chronic osteomyelitis is a common complication of acute osteomyelitis. | ||
<section begin="orthopaedics acute" /> | |||
== Clinical features == | == Clinical features == | ||
Symptoms include bone pain and fever. | Symptoms include bone pain and fever. | ||
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<section end="radiology" /> | <section end="radiology" /> | ||
== Management == | == Management == | ||
Management is usually conservative, with broad-spectrum IV antibiotics. In refractory cases or cases where there is an abscess, surgery may be necessary. | Management is usually conservative, with broad-spectrum IV antibiotics. In refractory cases or cases where there is an abscess, surgery may be necessary.<section end="orthopaedics acute" /> | ||
== Brodie abscess == | == Brodie abscess == | ||
Brodie abscess is a cystic region of pus and necrosis encapsulated by a rim of sclerotic bone. It occurs in the setting of chronic osteomyelitis in the metaphysis of long bones. It typically affects the distal tibia and is relatively more common in younger patients. It's managed with surgical opening, antibiotics, and autologous bone implantation. | Brodie abscess is a cystic region of pus and necrosis encapsulated by a rim of sclerotic bone. It occurs in the setting of chronic osteomyelitis in the metaphysis of long bones. It typically affects the distal tibia and is relatively more common in younger patients. It's managed with surgical opening, antibiotics, and autologous bone implantation. | ||