Osteomyelitis classification: Difference between revisions
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==Classification== | ==Classification== | ||
There are many types of classification schemes exist for osteomyelitis: | |||
*Lew and Waldvogel classify osteomyelitis according to duration and mechanism of infection (traditional classification)<ref name="LewWaldvogel1997">{{cite journal|last1=Lew|first1=Daniel P.|last2=Waldvogel|first2=Francis A.|title=Osteomyelitis|journal=New England Journal of Medicine|volume=336|issue=14|year=1997|pages=999–1007|issn=0028-4793|doi=10.1056/NEJM199704033361406}}</ref> | *Lew and Waldvogel classify osteomyelitis according to duration and mechanism of infection (traditional classification)<ref name="LewWaldvogel1997">{{cite journal|last1=Lew|first1=Daniel P.|last2=Waldvogel|first2=Francis A.|title=Osteomyelitis|journal=New England Journal of Medicine|volume=336|issue=14|year=1997|pages=999–1007|issn=0028-4793|doi=10.1056/NEJM199704033361406}}</ref> | ||
*Cierny and Mader classify osteomyelitis according to anatomy of [[bone]] infection and host [[physiology]]<ref name="MaderShirtliff1997">{{cite journal|last1=Mader|first1=Jon T.|last2=Shirtliff|first2=Mark|last3=Calhoun|first3=Jason H.|title=Staging and Staging Application in Osteomyelitis|journal=Clinical Infectious Diseases|volume=25|issue=6|year=1997|pages=1303–1309|issn=1058-4838|doi=10.1086/516149}}</ref> | *Cierny and Mader classify osteomyelitis according to anatomy of [[bone]] infection and host [[physiology]]<ref name="MaderShirtliff1997">{{cite journal|last1=Mader|first1=Jon T.|last2=Shirtliff|first2=Mark|last3=Calhoun|first3=Jason H.|title=Staging and Staging Application in Osteomyelitis|journal=Clinical Infectious Diseases|volume=25|issue=6|year=1997|pages=1303–1309|issn=1058-4838|doi=10.1086/516149}}</ref> | ||
:*The Cierny and Mader system offers a guide to treatment | :*The Cierny and Mader system offers a guide to treatment | ||
===Classification based on symptom chronology=== | |||
'''Lew and Waldvogel Etiologic System''' | '''Lew and Waldvogel Etiologic System''' | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nate Michalak, B.A.
Overview
Two classification schemes are currently used. Lew and Waldvogel classify osteomyelitis according to duration and mechanism of infection: hematogenouos osteomyelitis, contiguous-focus osteomyelitis, and osteomyeltis secondary to vascular insufficiency. Cierny and Mader classify osteomyelitis according to anatomy of bone infection and host physiology. This systems classifies the location of infection into 4 stages and the host's physiology into 3 levels of compromise.
Classification
There are many types of classification schemes exist for osteomyelitis:
- Lew and Waldvogel classify osteomyelitis according to duration and mechanism of infection (traditional classification)[1]
- Cierny and Mader classify osteomyelitis according to anatomy of bone infection and host physiology[2]
- The Cierny and Mader system offers a guide to treatment
Classification based on symptom chronology
Lew and Waldvogel Etiologic System
| Mechanism of Infection | Description |
|---|---|
| Hematogenous Osteomyelitis | Osteomyelitis develops after bacteremia |
| Contiguous-focus Osteomyelitis | Direct inoculation of bone via trauma/fracture, surgery, prosthetic devices, or spread from soft tissue |
| Osteomyelitis Secondary to Vascular Insufficiency | Reduced blood supply, usually in diabetic patients |
Cierny and Mader Staging System
| Classification | Description | |
|---|---|---|
| Anotomic Type | Stage 1 | Medullary osteomyeltitis: infection confined to the intramedullary bone surfaces |
| Stage 2 | Superficial osteomyelitis: true contiguous infection (bone surface undergoes necrosis at the base of a soft tissue wound) | |
| Stage 3 | Localized osteomyelitis: full-thickness, cortical sequestration | |
| Stage 4 | Diffuse osteomyelitis: through-and-through process requiring intercalary reconstruction of bone | |
| Physiological Class | A Host | Normal physiological, metabolic, and immunologic states |
| B Host | Local compromise, systemic compromise, or both | |
| C Host | Morbidity of treatment is worse than disease |
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.
- ↑ Mader, Jon T.; Shirtliff, Mark; Calhoun, Jason H. (1997). "Staging and Staging Application in Osteomyelitis". Clinical Infectious Diseases. 25 (6): 1303–1309. doi:10.1086/516149. ISSN 1058-4838.