Osteomyelitis physical examination: Difference between revisions

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[[Category:Emergency mdicine]]
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Latest revision as of 23:28, 29 July 2020

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 physical examination On the Web

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Risk calculators and risk factors for Osteomyelitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]; Nate Michalak, B.A.,Seyedmahdi Pahlavani, M.D. [3]

Overview

Patients with acute osteomyelitis may present with fever, local swelling, redness, and tenderness. Patients with with chronic osteomyelitis may present with additional signs such as draining sinus tracts, unhealing ulcers, unhealing fractures, Brodie's abscess, and unstable joints in cases of infected prosthesis. Commonly affected bones include long bones and lumbar vertebrae in hematogenous osteomyelitis, hips, knees and elbows in contiguous-focus osteomyelitis, and bones of the feet in osteomyelitis secondary to vascular insufficiency.

Physical Examination

  • Neonates might exhibit pseudoparalysis or pain with movement of the affected extremity (e.g., diaper changes). In children and adults, it depends on the site of involvement

Appearance of the Patient

Patients with osteomyelitis usually in pain, and they appear ill.

Vital Signs

Acute Osteomyelitis

Chronic Osteomyelitis

Patients with chronic osteomyelitis may present with acute signs in addition to the following:[2]

  • Draining sinus tract
  • Unhealing ulcers, particularly those over bony prominences or any ulcer in which bone is palpable by blunt probe[3]
  • Unhealing fractures
  • Unstable joint in patients with infection of their prosthesis.

Common Locations

Hematogenous Osteomyelitis
Contiguous-focus Osteomyleitis
Osteomyelitis Secondary to Vascular Insufficiency

Common sites of ostemyelitis in children include:[4]

Sites of osteomyelitis in children Prevalence
Femur 23-28%
Tibia 20-26%
Humerus 8-13%
Radius 5-6%
Phalanx 2-4%
Pelvis 5-9%
Calcaneus 4-6%
Ulna 5-6%
Metatarsal ~2%
Vertebrae 2-4%
Sacrum ~2%
Clavicle 1-2%
Skull ~1%

Gallery

References

  1. Lew, Daniel P.; Waldvogel, Francis A. (1997). "Osteomyelitis". New England Journal of Medicine. 336 (14): 999–1007. doi:10.1056/NEJM199704033361406. ISSN 0028-4793.
  2. 2.0 2.1 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.
  3. Lipsky, Benjamin A.; Berendt, Anthony R.; Deery, H. Gunner; Embil, John M.; Joseph, Warren S.; Karchmer, Adolf W.; LeFrock, Jack L.; Lew, Daniel P.; Mader, Jon T.; Norden, Carl; Tan, James S. (2004). "Diagnosis and Treatment of Diabetic Foot Infections". Clinical Infectious Diseases. 39 (7): 885–910. doi:10.1086/424846. ISSN 1058-4838.
  4. Kliegman, Robert (2016). Nelson textbook of pediatrics. Phialdelphia, PA: Elsevier. ISBN 978-1455775668.
  5. 5.0 5.1 5.2 "Dermatology Atlas".