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Osteomyelitis & Implant Complications - Coggle Diagram
Osteomyelitis & Implant Complications
osteomyelitis
inflammation of the bone and its marrow contents
types
acute hematogenous osteomyelitis
affects
young'uns
from umbilicus in neonates
humans
rare in SA
bacteremic episode
localizes in metaphyseal areas
turbulent blood flow in transitional areas bw metaphyeal capllaries and venous sinusoids
can cross into epiphysis and joint
CS
fever
lameness
anorexia
soft-tissue swelling
pain upon palpation
may spread or localize
if bone dies..
sequestra may form
avascular segments of bone surrounded by purulent exudate and fibrous tissue
may wall of as involucrum
highly vascular bone surrounding sequestrum
nidus from chronic lameness and reinfection
diagnostics
WBC elevated
rads
inital soft tissue swelling
new bone formation 2-3w
nuclear scintigraphy
sensitive
acute and chronic inflammation
FNA
blood cultures
treatment
broad spectrum abx initially 2-4w
change abx based on C&S in 4w
obvious abscesses and sequestra need to be surgically debrided and drained
good prognosis if
focal
metaphyseal
guarded prognosis if...
systemic
epiphyseal
muscle contracture
contamination
3-7d after
open fracture
surgery
extension from soft tissue infection
wounds show signs of inflammation, drainage
patient may haveqfever
elevated EBC
anorexia
pain
caused by
devitalized tissue
avascular mm or bone
hematoma
dead space
implants
may need to open and flush wounds
acute osteomyelitis from exogenous contamination
chronic osteomyelitis
septic arthritis
fungal osteomyelitis
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