Osteomyelitis physical examination

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Osteomyelitis Microchapters

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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.

Overview

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

Physical Examination

Vital Signs

Acute Osteomyelitis

Chronic Osteomyelitis

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

Common Locations

Hematogenous Osteomyelitis
  • Presence of transphyseal blood vessels and an immature growth plate in infants increase likelihood of infection spreading to epiphysis and joint cavity.
Contiguous-focus Osteomyleitis
  • Hip, knee, elbow due to prosthesis infection
  • Long bones due to fracture
Osteomyelitis Secondary to Vascular Insufficiency

Gallery

References

  1. 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.
  2. 2.0 2.1 2.2 "Dermatology Atlas".

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