Osteomyelitis 

  • Hematogenous (most common), direct or adjacent spread.
  • Staphiloccocus aureus MOST COMMON
  • Neisseria gonorrhoeae if sexually active.
  • Salmonella if pt has sickle cell disease
  • Pseudomona of pt is an IVDA or has DM
  • Fever, leukocytosis, localized swelling, erythema and pain.
  • X-Ray: normal for 2 weeks, then PERIOSTEAL ELEVATION (onion skinning lesion- 1st pic) also seen in osteosarcoma and Ewings sarcoma.
  • Pus, vascular insufficiency (vessels destroyed), ischemic necrosis, Sequestrum (necrotic bone) and Involucrum (new bone formation)
  • Blood culture, Bone bx and culture
  • Tx: antibiotics, surgical drainage
  • Complications: fracture, 2° amyloidosis, sinus tract formation, SCC of skin (from drainage), Broddie’s abscess (2nd pic)
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    Osteomyelitis -yelit OM… kids who meta-tate (meditate) have good AURA’s metaphysis, staph AUReus, sitting (seeding...
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