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DUREREA SISTEMULUI OSTEOMIOARTICULAR

DUREREA SISTEMULUI OSTEOMIOARTICULAR. Prof. Dr. Florin Catalin CIRSTOIU. DUREREA. Domina tablul clinic Diminua valoarea semiologica a altor simptome Semn subiectiv Imposibil de cuantificat pe o scala Subiectivism dual – medic si pacient. DUREREA ACUTA.

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DUREREA SISTEMULUI OSTEOMIOARTICULAR

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  1. DUREREA SISTEMULUI OSTEOMIOARTICULAR Prof. Dr. Florin Catalin CIRSTOIU

  2. DUREREA • Dominatablul clinic • Diminuavaloareasemiologica a altorsimptome • Semnsubiectiv • Imposibil de cuantificatpe o scala • Subiectivism dual – medic sipacient

  3. DUREREA ACUTA • FRACTURI – os normal/patologic • ENTORSE • LUXATII • TRAUMATISME MUSCULARE – rupturi / avulsiitendinoase/musculare • DUREREA POSTOPERATORIE IMEDIATA • OSTEOCONDRITA DISECANTA – BOALA KONIG

  4. DUREREA CRONICA • ARTROZE/ BOALA ARTROZICA • INFECTII OSOASE SPECIFICE/NESPECIFICE • BOLI METABOLICE OSOASE SI ARTICULARE • TUMORI OSOASE PRIMITIVE/ SECUNDARE • PATOLOGIE DEGENERATIVA OSOASA • PATOLOGIE DEGENERATIVA SPINALA

  5. DUREREA CRONICA ACUTIZATA • ARTROZE/ BOALA ARTROZICA • PATOLOGIA DEGENERATIVA SPINALA • TUMORI OSOASE • INFECTII OSOASE SPECIFICE / NESPECIFICE

  6. FRACTURA • DURERE IN PUNCT FIX • IMPOTENTA FUNCTIONALA • INTRANSMISIBILITATEA MISCARILOR IN FOCAR • CREPITATII OSOASE IN FOCAR • NU CEDEAZA LA ANTIALGICE SI PARTIAL LA IMOBILIZARE • SEMNE DE PROBABILITATE

  7. SEMNE DE PROBABILITATE ENTITATEA CLINICA SEMIOLOGIE EDEM TUMEFACTIE IMPOTENTA FUNCTIONALA HEMATOM ECHIMOZA • FRACTURI • ENTORSE • LUXATII • TRAUMATISME MUSCULARE

  8. TUMORILE OSOASE BENIGNE MALIGNE FRACTURA PE OS PATOLOGIC DUREREA DIN METASTAZELE OSOASE MULTIPLE OSTEOMUL OSTEOID • DURERE NOCTURNA • DURERE OSTEOCOPA • NU CEDEAZA LA ANTIALGICE UZUALE

  9. AFECTIUNI DEGENERATIVE ENTITATE CLINICA SEMNIFICATIE SEMIOLOGICA DURERE CU CARACTER PARTICULAR • COXARTROZA • GONARTROZA • ARTROZELE INTERDIGITALE • HERNIA DE DISC • PROLAPS DISCAL • ARTOZELE ACROMIOCLAVICULARE • UMARUL INGHETAT

  10. COXARTROZA • Definitie–afectiunecronicaDEGENERATIVA • A.P. –cartilajul - sinoviala - osulepifizar • Clinic –durerea - schiopatarea - redoarea - pozitiavicioasa

  11. Durerea • – in triunghiulluiScarpA • - iradieri– f. rargonalgiesolitara 10% • - obturatoare, falssciatalgie - la mers– 200 –1000 m • - scari, terendenivelat • Ortostatism • - dispare la repaus

  12. COXARTROZA

  13. CORELATIE RADIO-CLINICA

  14. OSTEOMILELITA ACUTA • Infectiebacteriana, diseminatahematogen de la un focar de intrare • Durere vie, pulsatila • Sindrominflamator • Predominant la copil, aproape de genunchi • Febra, frison • HEMOCULTURA POZITIVA

  15. DG. URGENT - SCINTIGRAFIA

  16. URGENTA MAJORA

  17. NECROZA, SECHESTRU OSOS

  18. OSTEOMIELITA VERTEBRALA

  19. TUBERCULOZA - durere sold, genunchi - hipotoniefesiera - contracturaantalgica - stare – accentuareasemnelorgeneralesi locale - pozitiivicioase : • flexie, abd, RE - apoi se fixeaza in flexie, add si RI - fistulizareabcese, luxatii intra si extra cotiloidiene

  20. ARTA SI TBC • Edvard Munch • “The Sick Child”

  21. CHIST OSOS ESENTIAL

  22. CHIST OSOS ESENTIAL

  23. HEMANGIOSARCOM - heterogrefa structurala

  24. FIBROSARCOM

  25. FIBROSARCOM - autogrefa structurala

  26. FIBROSARCOM - autogrefa structurala – degradare montaj

  27. FIBROSARCOM - autogrefa structurala - revizie

  28. PREOPERATORMETASTAZANEO. MAMAR

  29. PREOPERATORSCINTIGRAFIE OSOASAMETASTAZA UNICA

  30. METASTAZA COL FEMURALASPECT INTRAOPERATOR

  31. REZULTATE POSTOPERATORII Control la 6 luni

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