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DiseasesDB = 9367 |
DiseasesDB = 9367 |
MedlinePlus = 000437 |
MedlinePlus = 000437 |
eMedicineSubj = |
eMedicineTopic = |
MeshID = D010019 |
MeshID = D010019 |
}}
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== Presentation ==
==[[Osteomyelitis overview|Overview]]==


Generally, microorganisms may infect bone through one or more of three basic methods: via the [[bloodstream]], contiguously from local areas of infection (as in [[cellulitis]]), or penetrating [[Physical trauma|trauma]], including [[iatrogenic]] causes such as [[joint replacement]]s or internal fixation of [[Bone fracture|fracture]]s or [[endodontic therapy|root-canaled]] teeth.<ref name="Robbins" /> Once the bone is infected, [[leukocyte]]s enter the infected area, and in their attempt to [[phagocytosis|engulf]] the infectious organisms, release [[enzyme]]s that [[Lysis|lyse]] the bone. [[Pus]] spreads into the bone's blood vessels, impairing their flow, and areas of devitalized infected bone, known as ''sequestra'', form the basis of a chronic infection.<ref name="Robbins" /> Often, the body will try to create new bone around the area of [[necrosis]]. The resulting new bone is often called an [[involucrum]].<ref name="Robbins" /> On [[histology|histologic]] examination, these areas of necrotic bone are the basis for distinguishing between ''[[Acute (medicine)|acute]] osteomyelitis'' and ''[[wikt:chronic|chronic]] osteomyelitis''. Osteomyelitis is an infective process which encompasses all of the bone ([[wikt:osseous|osseous]]) components, including the bone marrow. When it is chronic it can lead to bone [[sclerosis]] and deformity.
==[[Osteomyelitis historical perspective|Historical Perspective]]==


In [[infant]]s, the infection can spread to the [[joint]] and cause [[arthritis]]. In children, large subperiosteal abscesses can form because the [[periosteum]] is loosely attached to the surface of the bone.<ref name="Robbins" />
==[[Osteomyelitis pathophysiology|Pathophysiology]]==


Because of the particulars of their blood supply, the [[tibia]], [[femur]], [[humerus]], [[vertebra]], the [[maxilla]], and the mandibular bodies are especially susceptible to osteomyelitis.<ref>{{cite web
==[[Osteomyelitis causes|Causes]]==
| url = http://www.emedicine.com/emerg/topic349.htm
| title = Osteomyelitis
| accessdate = 2007-11-11
| author = King MD, Randall W.
| coauthors = David Johnson, MD, FACEP
| date = 2006-07-13
| work = [[eMedicine]]
| publisher = [[WebMD]]
}}</ref> However, abscesses of any bone may be precipitated by trauma to the affected area. Many infections are caused by ''[[Staphylococcus aureus]]'', a member of the normal [[flora (microbiology)|flora]] found on the [[skin]] and [[mucous membrane]]s.


* Hematogenous long-bone osteomyelitis
==[[Osteomyelitis differential diagnosis|Differentiating Osteomyelitis from other Diseases]]==
:* Abrupt onset of high fever (fever is present in only 50% of neonates with osteomyelitis)
:* Fatigue
:* Irritability
:* Malaise
:* Restriction of movement (pseudoparalysis of limb in neonates)
:* Local edema, erythema, and tenderness
* Hematogenous vertebral osteomyelitis
:* Insidious onset
:* History of an acute bacteremic episode
:* May be associated with contiguous vascular insufficiency
:* Local edema, erythema, and tenderness
:* Failure of a young child to sit up normally2
* Chronic osteomyelitis
:* Non-healing ulcer
:* Sinus tract drainage
:* Chronic fatigue
:* Malaise


==References==
==[[Osteomyelitis epidemiology and demographics|Epidemiology and Demographics]]==
{{Reflist|2}}


==See also==
==[[Osteomyelitis risk factors|Risk Factors]]==
 
==[[Osteomyelitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
 
 
[[Osteomyelitis history and symptoms|History and Symptoms]] | [[Osteomyelitis physical examination|Physical Examination]] | [[Osteomyelitis laboratory findings|Laboratory Findings]] | [[Osteomyelitis imaging findings|Imaging Findings]] | [[Osteomyelitis other diagnostic studies|Other Diagnostic Studies]]
 
==Treatment==
 
[[Osteomyelitis medical therapy|Medical Therapy]] | [[Osteomyelitis surgery|Surgery]] | [[Osteomyelitis prevention|Prevention]] | [[Osteomyelitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Osteomyelitis future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
 
[[Osteomyelitis case study one|Case #1]]
 
==Related Chapters==
*[[Brodie abscess]]
*[[Brodie abscess]]


==External Links==
==External Links==
* [http://goldminer.arrs.org/search.php?query=Osteomyelitis Goldminer: Osteomyelitis]
* [http://goldminer.arrs.org/search.php?query=Osteomyelitis Goldminer: Osteomyelitis]
==Additional Resources==
* {{MerckManual|5|54|b}}
* {{Chorus|00298}}


{{Diseases of the musculoskeletal system and connective tissue}}
{{Diseases of the musculoskeletal system and connective tissue}}

Revision as of 16:10, 27 November 2012

For patient information click here

Osteomyelitis
Osteomyelitis of the tibia of a young child. Numerous abscesses in the bone show as radiolucency.
ICD-10 M86
ICD-9 730
DiseasesDB 9367
MedlinePlus 000437
MeSH D010019

Osteomyelitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Osteomyelitis from Other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications, and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Osteomyelitis On the Web

Most recent articles

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Review articles

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Powerpoint slides

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NICE Guidance

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Directions to Hospitals Treating Osteomyelitis

Risk calculators and risk factors for Osteomyelitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]


Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Osteomyelitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

External Links

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