Osteomyelitis 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.
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.