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Osteomyelitis: Difference between revisions
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<section begin="orthopaedics" /><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 begin="orthopaedics" /><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" /> | ||
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. | 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. | ||
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. | |||
== Clinical features == | == Clinical features == | ||
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Conventional radiography may not visualise pathology in the first 2 weeks of the disease. If the symptoms have lasted <2 weeks, CT or MRI is indicated. If it has lasted more than 2 weeks, radiography is sufficient and will show osteolysis, periosteal reaction, and bone destruction. | Conventional radiography may not visualise pathology in the first 2 weeks of the disease. If the symptoms have lasted <2 weeks, CT or MRI is indicated. If it has lasted more than 2 weeks, radiography is sufficient and will show osteolysis, periosteal reaction, and bone destruction. | ||
<section end="radiology" /> | <section end="radiology" /> | ||
== Management == | |||
Management is usually conservative, with broad-spectrum IV antibiotics. In refractory cases or cases where there is an abscess, surgery may be necessary. | |||
== Brodie abscess == | == Brodie abscess == | ||