Osteomyelitis

Definition Osteomyelitis
Osteomyelitis is an infection of the bone and bone
medulla well as non-pyogenic or pyogenic
infections, for example mikobacterium tuberculosa.
It can remain localized or can spread through bone
marrow involves the cortex, kanselosa tissue, and
periosteum. It can be acute or chronic

etiology

Basically, all types of organisms, including

viruses, parasites, fungi, and bacteria, can
cause osteomyelitis, but is most often caused
by certain pyogenic bacteria and mycobacteria

RISK FACTOR

Diabetes mellitus
Patients receiving hemodialysis
People with poor immune systems / bad
Sickel cell disease
Intravenous drug abuse
Age, especially regarding baby and children
Alkoholisme
Long-term steroid use
Chronic joint disease
Trauma (orthopedic surgery or open fracture
The use of prosthetic orthopedic

classification

Osteomyelitis can generally be classified

based on the clinical course, osteomyelitis
acute, subacute, and chronic. It depends on
the intensity of the infection and symptoms
related.

clinical symptoms

a. Clinical symptoms of acute osteomyelitis

In early disease, systemic symptoms such as febrile,
anorexia, and malaise prominent, while the local
symptoms such as swelling or cellulitis not appear.
In newborns, infants looked nervous, and irritable.
Usually more common in infants with 'high risk' as
premature, underweight babies history of difficult labor
or umbilical artery catheters
In adults, the most common place is on the predilection
thorakolumbal vertebra. Can only attack patients with a
history of problems in the urinary tract

b. Clinical symptoms of subacute osteomyelitis

Haematogenous Subacute osteomyelitis usually found in children
and adolescents. Clinical features that can be found is muscle
atrophy, local pain, a little swelling, and can also be crippled
sufferer. Feel pain in the area around the joint for a few weeks or
months. The patient's body temperature is usually normal.
c. Clinical symptoms of choronic osteomyelitis
Localized bone pain, redness, and drainage around the affected
area often arise. On physical examination findings sinus, fistula or
cicatricial scar with tenderness, deformity, instability, and signs of
the disorder vascularization, range of motion, and neurological
status. May be found protruding sekuestrum

diagnosis
radiography
In osteomyelitis of the extremities, photo plain radiographs and bone
scintigrafi is the primary screening tool. Radiographic evidence of
osteomyelitis will not appear until approximately two weeks after the onset
of infection
Scintigrafi bone
For imaging nuclir, Technetium Tc-99m methylene difosfonat is the main
agent of choice. The sensitivity of this examination is limited to the first
week and not at all specific
MRI (Magnetic resonance imaging)
Magnetic resonance imaging (MRI) is helpful in detecting osteomyelitis. MRI
is superior when compared to radiography, CT scans and bone scintigrafi
MRI had a sensitivity of 90-100% in the detection of osteomyelitis

 Ultrasonografi dan CT (computed tomographic) scan

Ultrasonography and CT (computed tomographic)
scan can help diagnose osteomyelitis. Ultrasound can
show the changes as early as 1-2 days after onset of
symptoms. Ultrasound can show abnormalities
including soft tissue abscesses or accumulation of
fluid (such as abscesses) and periosteal elevation. 2
Ultrasound can also be used to guide the conduct of
aspiration. However, ultrasound is not used to
evaluate bone cortex.

TREATMENT
acute osteomyelitis
resting the affected limb (if necessary use a splint or traction)
and immediately given antibiotics. Broad-spectrum antibiotics
effective against gram-positive and gram-negative given
directly pending the outcome of the bacteria culture.
Antibiotics are given for 3-6 weeks to see the general state of
the patient and erythrocyte sedimentation rate
Osteomyelitis subacute
antibiotics in accordance with gram group, culture, and
sensitivity must be initiated intravenously for 2-7 days,
followed by oral antibiotics for 6 weeks

 Treatment of Chronic Osteomyelitis

1. Antibiotics
Chronic osteomyelitis can not be treated with
antibiotics solely antibiotics aimed at:
Preventing the spread of infection in an otherwise
healthy bones
Controlling exacerbations
2. Measures operativeOperative procedure performed
when acute exacerbation phase has subsided after
administration and adequate antibiotic treatment.