Osteomyelitis history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Patient history is important to establish a diagnosis of osteomyelitis. Common histories include: [[intravenous drug use]], [[bacteremia]], recent open [[fracture]] or [[surgery]], and [[diabetes]]. Common symptoms include: chills, [[fever]], [[malaise]], local pain and warmth, [[edema]], and [[erythema]]. Fever is typically absent in diabetic patients with osteomyelitis secondary to vascular insufficiency and patients with an infected [[prosthesis]]. | Patient history is important to establish a diagnosis of osteomyelitis. Common histories include: [[intravenous drug use]], [[bacteremia]], recent open [[fracture]] or [[surgery]], and [[diabetes]]. Common symptoms include: chills, [[fever]], [[malaise]], local pain and warmth, [[edema]], and [[erythema]]. Fever is typically absent in diabetic patients with osteomyelitis secondary to vascular insufficiency and patients with an infected [[prosthesis]].<br> | ||
The presence of a '''draining sinus tract''' is '''pathognomic''' of chronic osteomyelitis. | |||
==History and Symptoms== | ==History and Symptoms== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nate Michalak, B.A.,Seyedmahdi Pahlavani, M.D. [2]
Overview
Patient history is important to establish a diagnosis of osteomyelitis. Common histories include: intravenous drug use, bacteremia, recent open fracture or surgery, and diabetes. Common symptoms include: chills, fever, malaise, local pain and warmth, edema, and erythema. Fever is typically absent in diabetic patients with osteomyelitis secondary to vascular insufficiency and patients with an infected prosthesis.
The presence of a draining sinus tract is pathognomic of chronic osteomyelitis.
History and Symptoms
Patient History
A detailed and thorough history from the patient is necessary. Specific areas of focus when obtaining a history from the patient based on specific types of osteomyelitis include:
- Hematogenous Osteomyelitis:
- Contiguous-focus Osteomyelitis:
- Recent open fracture
- Recent surgery, especially orthopedic surgery
- Prosthesis
- Osteomyelitis Secondary to Vascular Insufficiency:
Common symptoms
- Local:
Special Considerations
- Diabetic patients with osteomyelitis secondary to vascular insufficiency typically do not have fever or inflammation.
- Diabetic patients with advanced neuropathy may not feel pain.
- Fever is typically absent in patients with infected prosthesis.
- Patients with vertebral osteomyelitis may have generalized neck and back pain.
- The presence of a draining sinus tract is pathognomic of chronic osteomyelitis.
References
- ↑ Lew, Daniel P.; Waldvogel, Francis A. (1997). "Osteomyelitis". New England Journal of Medicine. 336 (14): 999–1007. doi:10.1056/NEJM199704033361406. ISSN 0028-4793.
- ↑ Caputo, Gregory M.; Cavanagh, Peter R.; Ulbrecht, Jan S.; Gibbons, Gary W.; Karchmer, Adolf W. (1994). "Assessment and Management of Foot Disease in Patients with Diabetes". New England Journal of Medicine. 331 (13): 854–860. doi:10.1056/NEJM199409293311307. ISSN 0028-4793.
- ↑ Lew, Daniel P; Waldvogel, Francis A (2004). "Osteomyelitis". The Lancet. 364 (9431): 369–379. doi:10.1016/S0140-6736(04)16727-5. ISSN 0140-6736.
- ↑ Vazquez M (2002). "Osteomyelitis in children". Curr. Opin. Pediatr. 14 (1): 112–5. PMID 11880745.