Osteomyelitis is an inflammation of the bone, bone marrow and surrounding soft tissue caused by the pyogenic bacteria.OR Osteomyelitis is infection and inflammation of the bone or bone marrow.
Common site or joint: the common site of osteomyelitis are- 1. Metaphysical region of the long bone, 2.Hip joint, 3.Knee joint and ankle joint.
Causes/ cause/ Agent/ Factor responsible for Osteomyelitis:
- Organism related cause: Staphylococcus aureas (60-85% occur acute osteomyelitis), Streptococcus hemolyticus, Salmonella, pseudomonas, pneumococcus, Clostridium welchii, Coli and Hemophilus influenza.
- Host 🙁 a). Children– 88% due to fall. (b). Adult– 12% is common. (c). Sex: male: female= 4:1, (d). Low socio-economic condition.
- Environmental factors: Poor nutrition, Poor immune status, infection, Anemia, Poor personal hygiene, Dental carries, Umbilical sepsis.
Classification of Osteomyelitis:
- On the basis of duration: there are three types-a. Acute Osteomyelitis, b. Sub-acute osteomyelitis, c. chronic osteomyelitis.
- On the basis of etiology: Bacterial Osteomyelitis (Pyogenic Osteomyelitis, Tubercular Osteomyelitis, Skeletal osteomyelitis). b. Viral Osteomyelitis, c. Fungal Osteomyelitis, d. Parasitical Osteomyelitis.
Clinical feature: Fever (High), Pain, Headache, Swelling, Profuse sweating, limitation of movement, tenderness, local erythema, effusion, general feature of anemia, sign of dehydration.
In children: Restlessness, lethargy, Reelected to feed.
- Routine examination: Complete blood count (CBC), Joint aspiration and c/s.
- Special examination: X-Ray of affected area (after 10 days).Finding: look haziness and elevation of the peritoneum.
- Isotone examination.
- CT scan / MRI.
Differential diagnosis : Acute septic arthritis, Scurvy, Haemarthrosis, Acute poliomyelitis, Cellulitis.
- General management:
- Absolute bed rest.
- Reassurance the patient and her family.
- Protect the affected part with splint.
- Taped sponging.
- Provide Intravenous fluid.
- Apparatus of external fixation will be Check freak frequently. monitor .
- Nutrition supplement.
- Maintain muscle and joint
- Psychotherapy and counseling
- Health education.