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Acute osteomyelitis

Acute osteomyelitis. It is inflammation of the bone and its marrow. Aetiology - Most commonly – staph aureus, streptococci pyogens, strept. Pneumoniae, pseudomonas, proteus. Under 4 yrs of age, - haemophilous influenza. Site of entry- Skin infection, cellulitis, boils, abscess.

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Acute osteomyelitis

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  1. Acute osteomyelitis • It is inflammation of the bone and its marrow. Aetiology- Most commonly – staph aureus, streptococci pyogens, strept. Pneumoniae, pseudomonas, proteus. Under 4 yrs of age, - haemophilous influenza.

  2. Site of entry- • Skin infection, cellulitis, boils, abscess. • Dental infection, IV canula, syringe, • ENT infection, lungs, UTI (catheter). Pathophysiology- • Port of entry  blood metaphysis of bone (because it has high blood supply) blood stasis – deficient phagocytosis.

  3. Spasm of blood vessels in case of trauma hypoxia, inflammation stage of suppuration in chronic , stage of necrosis (sequestrum)  stage of new bone formation  stage of restoration and remodelling. • During inflamation- • Venous stasis. • Polymorphonuclear cell migrant. • Exudate formation. • Thrombosis of vessels.

  4. Stage of suppuration. pus gets into joint cavity or medullary cavity. • Stage of necrosis. Because of venous stasis, thrombosis of vessels increase intraoseous pressure stripping periosteum by pus. Blood supply of the bone will be impaired that will lead to necrosis.

  5. Stage of new bone fomation.- Formation of new bone takes place from the deeper layer of periosteum. Cl/ft; - find out h/o lesion at the entry site (primary site). • H/O trauma. • Pain and tenderness. • Fever, swelling. • Loss of function.

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  7. On examination- • Increased local temperature. • Swelling , tenderness. • Lymphadenopathy. D/d • Cellulitis. • Septic arthritis. • Rheumatism. • Acute poliomyelitis.

  8. Investigation; -CBC. -Pus for c/s. -blood for c/s. -stool for c/s- (salmonella). -X-ray, no positive findings till 1-2 wks. After 2 wks, there will be soft tissue swelling. -MRI. -CT- scan. -USG- subperiosteal abscess.

  9. Treatment; • Symptomatic. • Antiboitics. • Rest to limb. • Surgery for exploration and evacuation.

  10. Management of acute osteomyelitis.

  11. Complication- • General complications- septicemia. • Local complications – septic arthritis. - pathological fractures. - growth plate damage. - Ch. Osteomyelitis.

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