Nbr - Osteomyelitis

Front 1

What is osteomyelits?

Back 1

Nelaton is thought to be the first one to use the term osteomyelits to describe na infeciton fo bone and marrow in 1844. Infection of the cortex alone without marrow involvemnt ismore appropiately describes s Osteitis. Infection fo the perisoteum alonme should be called perostitis

Front 2

What are the common pahtogens seen n ostoemyelits

Back 2

mANY STudies have showen tha tsterpococcus specioas nad staphyloccous aurus wer hte most comon pathogens in osteomyelit.s Anareobes aer not common, but when isoalted wer often gamp ostive with petosterpotccocus specis most comon. Bacteorids speciase are ht most commomn gram - negativme anearobic orniism in osteomelitis.

Front 3

What is thetiology of pedal osteomyelits/

Back 3

Whle neruopathi ulcedratio is the most comon conditon that can leatd to pedal ostoemyeikts, puncute wounds can easily led to OM if not treated prperly. Hematogenous osteomyelits is een i nchildren but is very raer in adults. open fracurtes and psot bony surgery cane be predispose dto ostoemyelits

Front 4

Classificatgion of osteomyelits?

Back 4

There are two classification systems often used to classfiy ostoemyelit.s
The Cerny Mader was developed to describe long bone osteomyelits. It needs to be modified to describe pedal ostoemelits. The system is bawsed on the anatomy fo the bone ath physol\gical staus fo the ost.
Waldvogel calssfication isa n etiolog system. Bot h systems can bue used cocnrurrently to effectively describe osteomyelitss and to develop treatment guidlesn

Front 5

Antibiotic therapy for ostoemyelits?

Back 5

Most authors agree that infection in patient with diabetes is poly-microbial/. Patient shoudl be startre4de with an empirc broad specrum atibiot. The mdicatin may be adjusted based on results of wound and bone cuturs. In most case inravenous antibiots are efficaious than oral antibiotics. The duratin o ftibiot cours is not clear. Most clincian place pation on six week coursse but hte lenght can vary between 4 and 13 weeks.

Front 6

What needs to be exaine when evaluting diabeti patient with osteomyeits.

Back 6

Examination fo patient with possible osteomyelits hsoud not be devied form any other typ of physical examinaiton. a careful hsitory of the ulcer is extemely helpful. even i nthe case of a sever infection, many of htose patient will not realte any constituion symptoms. past medical nad surgical hsitory asleergy, current mediaciojnt cna help determin the apprporiat ecourse of treatment. Vital signs are improtant even thogh may diabetis will not mout fever in response to theri infection A finger stick t determin bood glucose may provid a clue ot the severity fo infecitn A compelte physical exame can proideinformaiton need to char ascucessful tratrmnt plant The uslcer and surrohding soft tissue need to ve evaluated througly. An y exposed obne is hightly suggestive of osteomelitis. Kdiney funciton need to ve evaluated to dose the anitmciribial therapy plroper. blod culturs ar nto awlay necessary but need if hte paeint apperas septic. Radiographi examinantion may not provid much infoamtion aobut osteomyelits ub t can provid good detail for any structual deformity

Front 7

Role of Boen scan in diagonose of oseomyoleit.

Back 7

hILY SENSITIVE BUT POOR SPECIFICTY.
tC 99, METHYLENDIPHOSPONATE SCANNIN, GALLIUM 67, INDIU 111 labeled leukoceit.

Front 8

Role of MRI indiagones of osteomyelits.

Back 8

The advantagoe fMRI is that is no-invasive bu tosme patient may have coautrophobia na not abel to unego the prcedure. , very good sensitiviyt and speicificty

Front 9

Other diagnosis modalities for osetomyelits

Back 9

probing ot boen apperas to gthe most cost effective metho to make the diagnosis of OM

Front 10

Invasiv ediagnosis of OM

Back 10

gold standar is bone bioposy.
Bolne culture form the biopsy can easily be contaminated yeilding false reuslt, but it shoul nnot affect antimcirobial therapy because the organism that infected the soft tissue and th bone shoud be simlar. If sugery is perfoemd ot remove the ostoemyelit boen the specimen should alway s be sent to pahtolgy for examination

Front 11

Treatmetn of ostoemyleit.s

Back 11

Becaue osetomyelits in most case is the exenso f osfot tissue infection medical mangement shoul no be dfifernt form thos e proved ot ulcer. optimal mangagement requeis msutlidsciplinary apporac. Medical condions sucha s hyper gycemia,k nephrpathy or cardia insufficency need to be addresed wheil treating hte osteomyelits. Antimicrobia therapy wil help control and tera seps. The woudn and any expsed bones needs to be debride aggesivley. The uslcerated areneedds to be offloaded using th emethos the provider is most experinced with. The ownd bed shohld be kept k=clenased and mosit using approporiat wound car product. Any dieficien circulation to the ulcer areane eeds to be restoere for hte uslce rand to bone to have ahcnae tgo heal. Surgical femoal of the bone followed by delay secondar closure ahs been shown by nmay augthors to be th most effective method to trat osteomelits. Ins some cases , skin graft, andavcemetn flap, rotation flap, or afeet tissue transfer may be requeired to cove a large defect casue gy the infect ulcer oith osteomyeltis.

Front 12

What is sequestration?

Back 12

IT is a segment of dead dvasculariaze boen due to Haversion and Vokman cnal and osteocyt destrutcion The proces si highly suggestiv oe fostoemelits. Diabetic neopathic arthropathy may have simialr presentation.

Front 13

What is involucrum?

Back 13

As the infection progresses, the periosteum is elevat4ed by pruelnt material the new boen formation uer the periosteum is called involucrm. Tis si alse suggreestive osteomyelits.

Front 14

What is cloac?

Back 14

cloaca is the formation seen at bone-perostal inteface to extreude sweustrum and other necrotic producdct form the infected bone.

Front 15

How does peropheral vascual diseae affect ostoemyelits.

Back 15

The prescenc of PVD msut be recognized and treated for paeint with OM. If not reate dthe dieae will prolong hospitaliztn and may evne lead unnecessar amputation.