Osteomyelitis physical examination: Difference between revisions
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===Acute Osteomyelitis=== | ===Acute Osteomyelitis=== | ||
*Swelling | *[[Swelling]] | ||
*Redness | *[[Redness of the skin|Redness]] | ||
*Tenderness (except in diabetic patients with advanced [[neuropathy]]) | *Tenderness (except in diabetic patients with advanced [[neuropathy]]) | ||
===Chronic Osteomyelitis=== | ===Chronic Osteomyelitis=== | ||
Patients with chronic osteomyelitis may present with acute signs in addition to the following: | Patients with chronic osteomyelitis may present with acute signs in addition to the following: | ||
* | *Sequestra | ||
*Draining [[sinus | *Draining [[sinus]] tract | ||
*Thickened [[periosteum]] | *Thickened [[periosteum]] | ||
*Unhealing [[ulcers]], particularly those over bony prominences or any ulcer in which bone is palpable by blunt probe<ref name="LipskyBerendt2004">{{cite journal|last1=Lipsky|first1=Benjamin A.|last2=Berendt|first2=Anthony R.|last3=Deery|first3=H. Gunner|last4=Embil|first4=John M.|last5=Joseph|first5=Warren S.|last6=Karchmer|first6=Adolf W.|last7=LeFrock|first7=Jack L.|last8=Lew|first8=Daniel P.|last9=Mader|first9=Jon T.|last10=Norden|first10=Carl|last11=Tan|first11=James S.|title=Diagnosis and Treatment of Diabetic Foot Infections|journal=Clinical Infectious Diseases|volume=39|issue=7|year=2004|pages=885–910|issn=1058-4838|doi=10.1086/424846}}</ref> | *Unhealing [[ulcers]], particularly those over bony prominences or any ulcer in which bone is palpable by blunt probe<ref name="LipskyBerendt2004">{{cite journal|last1=Lipsky|first1=Benjamin A.|last2=Berendt|first2=Anthony R.|last3=Deery|first3=H. Gunner|last4=Embil|first4=John M.|last5=Joseph|first5=Warren S.|last6=Karchmer|first6=Adolf W.|last7=LeFrock|first7=Jack L.|last8=Lew|first8=Daniel P.|last9=Mader|first9=Jon T.|last10=Norden|first10=Carl|last11=Tan|first11=James S.|title=Diagnosis and Treatment of Diabetic Foot Infections|journal=Clinical Infectious Diseases|volume=39|issue=7|year=2004|pages=885–910|issn=1058-4838|doi=10.1086/424846}}</ref> | ||
*Unhealing [[fractures]] | *Unhealing [[fractures]] | ||
*[[Brodie's abscess]] | *[[Brodie's abscess]] | ||
*Unstable joint in patients with | *Unstable joint in patients with [[prosthesis]] infection | ||
===Common Locations=== | ===Common Locations=== | ||
=====Hematogenous Osteomyelitis===== | =====Hematogenous Osteomyelitis===== | ||
*Long bone metaphysis (typically tibia and femur) in children | *[[Long bone]] [[metaphysis]] (typically [[tibia]] and [[femur]]) in children | ||
:*Presence of transphyseal blood vessels and an immature growth plate in infants increase likelihood of infection spreading to epiphysis and joint cavity. | :*Presence of transphyseal blood vessels and an immature growth plate in infants increase likelihood of infection spreading to [[epiphysis]] and joint cavity. | ||
*Lumbar vertebrae in elderly patients | *[[Lumbar vertebrae]] in elderly patients | ||
:*Vertebral osteomytelitis involves adjacent vertebrae and intervertebral disc | :*Vertebral osteomytelitis involves adjacent [[vertebrae]] and [[intervertebral disc]] | ||
=====Contiguous-focus Osteomyleitis===== | =====Contiguous-focus Osteomyleitis===== | ||
| Line 36: | Line 36: | ||
=====Osteomyelitis Secondary to Vascular Insufficiency===== | =====Osteomyelitis Secondary to Vascular Insufficiency===== | ||
* Toes, metatarsal heads, and tarsal bones | * [[Toes]], [[metatarsal]] heads, and [[tarsal]] bones | ||
==Gallery== | ==Gallery== | ||
Revision as of 20:17, 18 April 2016
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Osteomyelitis Microchapters |
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Osteomyelitis physical examination On the Web |
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American Roentgen Ray Society Images of Osteomyelitis physical examination |
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Risk calculators and risk factors for Osteomyelitis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]; Nate Michalak, B.A.
Overview
Physical Examination
Vital Signs
Acute Osteomyelitis
- Swelling
- Redness
- Tenderness (except in diabetic patients with advanced neuropathy)
Chronic Osteomyelitis
Patients with chronic osteomyelitis may present with acute signs in addition to the following:
- Sequestra
- Draining sinus tract
- Thickened periosteum
- Unhealing ulcers, particularly those over bony prominences or any ulcer in which bone is palpable by blunt probe[1]
- Unhealing fractures
- Brodie's abscess
- Unstable joint in patients with prosthesis infection
Common Locations
Hematogenous Osteomyelitis
- Long bone metaphysis (typically tibia and femur) in children
- Presence of transphyseal blood vessels and an immature growth plate in infants increase likelihood of infection spreading to epiphysis and joint cavity.
- Lumbar vertebrae in elderly patients
- Vertebral osteomytelitis involves adjacent vertebrae and intervertebral disc
Contiguous-focus Osteomyleitis
- Hip, knee, elbow due to prosthesis infection
- Long bones due to fracture
Osteomyelitis Secondary to Vascular Insufficiency
- Toes, metatarsal heads, and tarsal bones
Gallery
-
![Osteomyelitis. With permission from Dermatology Atlas.[2]](/images/3/3a/Osteomyelitis01.jpg)
Osteomyelitis. With permission from Dermatology Atlas.[2]
-
![Osteomyelitis. With permission from Dermatology Atlas.[2]](/images/d/d0/Osteomyelitis02.jpg)
Osteomyelitis. With permission from Dermatology Atlas.[2]
-
![Osteomyelitis. With permission from Dermatology Atlas.[2]](/images/7/7a/Osteomyelitis03.jpg)
Osteomyelitis. With permission from Dermatology Atlas.[2]
![Osteomyelitis. With permission from Dermatology Atlas.[2]](/index.php/File:Osteomyelitis01.jpg)
![Osteomyelitis. With permission from Dermatology Atlas.[2]](/index.php/File:Osteomyelitis02.jpg)
![Osteomyelitis. With permission from Dermatology Atlas.[2]](/index.php/File:Osteomyelitis03.jpg)
References
- ↑ Lipsky, Benjamin A.; Berendt, Anthony R.; Deery, H. Gunner; Embil, John M.; Joseph, Warren S.; Karchmer, Adolf W.; LeFrock, Jack L.; Lew, Daniel P.; Mader, Jon T.; Norden, Carl; Tan, James S. (2004). "Diagnosis and Treatment of Diabetic Foot Infections". Clinical Infectious Diseases. 39 (7): 885–910. doi:10.1086/424846. ISSN 1058-4838.
- ↑ 2.0 2.1 2.2 "Dermatology Atlas".