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Osteomyelitis

Osteomyelitis. Inflammation with an Infectious cause. Osteomyelitis affects the bones; septic arthritis affects the joints. Etiology Osteomyelitis. Hematogenous Secondary to adjacent infection Direct inoculation Vascular insufficiency.

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Osteomyelitis

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  1. Osteomyelitis Inflammation with an Infectious cause. Osteomyelitis affects the bones; septic arthritis affects the joints.

  2. Etiology Osteomyelitis • Hematogenous • Secondary to adjacent infection • Direct inoculation • Vascular insufficiency Primary agents causing osteomyelitis: staph, strep, gonorrhea

  3. Etiology Hematogenous Direct inoculation Agents staph, strep, gonorrhea, viral, post rubella Septic Arthritis

  4. Development of Osteomyelitis Classification of osteomyelitis Acute Chronic Sinus tracts form, bone destruction

  5. Development of Osteomyelitis • Bacteria invade bone • Pressure within bone increases • Periosteum elevates and bone DIES • Infected bone separates = sequestrum • Separated periosteum produces new bone = involcrum • Sinus tract forms

  6. Signs and symptoms Acute 24-48 hrs post-surgery Pain Swelling, erythemia Pseudoarthrosis Chronic Diagnostic tests X-ray, no initial bone changes CT, MRI. biopsy Culture Late bone changes with bone destruction Osteomyelitis

  7. Signs and symptoms Painful Loss of motion High fever Less likely to become chronic Diagnostic tests Lab studies X-rays show synovial effusion Arthrocenthesis with culture Septic Arthritis

  8. Synovial inflammation! Comparison acute rheumatoid arthritis and septic arthritis of the joint! Purulent exudate!

  9. Nursing Diagnosis Alteration in comfort Potential for injury: fracture Hyperthemia Knowledge deficit Interventions Acute: prevent, identify source, short-term antibiotics Chronic: opt nutrition, splint for support, surgery,hyperbaric O2, muscle flap, long term antibiotics Management

  10. If only I had taken those antibiotics! Avoid the pain and grief of chronic osteomyelitis!

  11. Tuberculosis of Bone and Spine • Source • Signs and symptoms: vertebral collapse, pain, deformity (Potts fx), systemic as night sweats, anemia • Diagnosis • Treatment

  12. Test Yourself! • Sixty days following her TKR, Ms. K calls her physician to report “a little pain and swelling “ around her knee. What advice would you give her? • a. “That is expected.” • b. “Wait and see what happens.” • c. “Let me check the knee.” • d. “You may need an antibiotic.”

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