Osteomyelitis history and symptoms: Difference between revisions
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== History and Symptoms == | == History and Symptoms == | ||
Generally, microorganisms may infect bone through one or more of three basic methods: via the [[bloodstream]], contiguously from local areas of infection (as in [[cellulitis]]), or penetrating [[Physical trauma|trauma]], including [[iatrogenic]] causes such as [[joint replacement]]s or internal fixation of [[Bone fracture|fracture]]s or [[endodontic therapy|root-canaled]] teeth. Once the bone is infected, [[leukocyte]]s enter the infected area, and in their attempt to [[phagocytosis|engulf]] the infectious organisms, release [[enzyme]]s that [[Lysis|lyse]] the bone. [[Pus]] spreads into the bone's blood vessels, impairing their flow, and areas of devitalized infected bone, known as | Generally, microorganisms may infect bone through one or more of three basic methods: via the [[bloodstream]], contiguously from local areas of infection (as in [[cellulitis]]), or penetrating [[Physical trauma|trauma]], including [[iatrogenic]] causes such as [[joint replacement]]s or internal fixation of [[Bone fracture|fracture]]s or [[endodontic therapy|root-canaled]] teeth. Once the bone is infected, [[leukocyte]]s enter the infected area, and in their attempt to [[phagocytosis|engulf]] the infectious organisms, release [[enzyme]]s that [[Lysis|lyse]] the bone. [[Pus]] spreads into the bone's blood vessels, impairing their flow, and areas of devitalized infected bone, known as sequestra, form the basis of a chronic infection. Often, the body will try to create new bone around the area of [[necrosis]]. The resulting new bone is often called an [[involucrum]]. On [[histology|histologic]] examination, these areas of necrotic bone are the basis for distinguishing between [[Acute (medicine)|acute]] osteomyelitis and [[wikt:chronic|chronic]] osteomyelitis. Osteomyelitis is an infective process which encompasses all of the bone ([[wikt:osseous|osseous]]) components, including the bone marrow. When it is chronic it can lead to bone [[sclerosis]] and deformity. | ||
In [[infant]]s, the infection can spread to the [[joint]] and cause [[arthritis]]. In children, large subperiosteal abscesses can form because the [[periosteum]] is loosely attached to the surface of the bone. | In [[infant]]s, the infection can spread to the [[joint]] and cause [[arthritis]]. In children, large subperiosteal abscesses can form because the [[periosteum]] is loosely attached to the surface of the bone. | ||
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:* [[Malaise]] | :* [[Malaise]] | ||
:* Restriction of movement (pseudoparalysis of limb in neonates) | :* Restriction of movement (pseudoparalysis of limb in neonates) | ||
:* Local [[edema]], erythema, and tenderness | :* Local [[edema]], [[erythema]], and tenderness | ||
* Hematogenous vertebral osteomyelitis | * Hematogenous vertebral osteomyelitis | ||
:* Insidious onset | :* Insidious onset | ||
:* History of an acute bacteremic episode | :* History of an acute bacteremic episode | ||
:* May be associated with contiguous vascular insufficiency | :* May be associated with contiguous vascular insufficiency | ||
:* Local edema, erythema, and tenderness | :* Local [[edema]], [[erythema]], and tenderness | ||
:* Failure of a young child to sit up | :* Failure of a young child to sit up normally | ||
* Chronic osteomyelitis | * Chronic osteomyelitis | ||
:* Non-healing ulcer | :* Non-healing ulcer | ||
:* Sinus tract drainage | :* Sinus tract drainage | ||
:* Chronic fatigue | :* Chronic [[fatigue]] | ||
:* Malaise | :* [[Malaise]] | ||
==References== | ==References== | ||
Revision as of 15:16, 27 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
History and Symptoms
Generally, microorganisms may infect bone through one or more of three basic methods: via the bloodstream, contiguously from local areas of infection (as in cellulitis), or penetrating trauma, including iatrogenic causes such as joint replacements or internal fixation of fractures or root-canaled teeth. Once the bone is infected, leukocytes enter the infected area, and in their attempt to engulf the infectious organisms, release enzymes that lyse the bone. Pus spreads into the bone's blood vessels, impairing their flow, and areas of devitalized infected bone, known as sequestra, form the basis of a chronic infection. Often, the body will try to create new bone around the area of necrosis. The resulting new bone is often called an involucrum. On histologic examination, these areas of necrotic bone are the basis for distinguishing between acute osteomyelitis and chronic osteomyelitis. Osteomyelitis is an infective process which encompasses all of the bone (osseous) components, including the bone marrow. When it is chronic it can lead to bone sclerosis and deformity.
In infants, the infection can spread to the joint and cause arthritis. In children, large subperiosteal abscesses can form because the periosteum is loosely attached to the surface of the bone.
Because of the particulars of their blood supply, the tibia, femur, humerus, vertebra, the maxilla, and the mandibular bodies are especially susceptible to osteomyelitis. However, abscesses of any bone may be precipitated by trauma to the affected area. Many infections are caused by Staphylococcus aureus, a member of the normal flora found on the skin and mucous membranes.
- Hematogenous long-bone osteomyelitis
- Hematogenous vertebral osteomyelitis
- Chronic osteomyelitis