Acute osteomyelitis

Acute osteomyelitis

Acute osteomyelitis

Etiopaho-
1 staph.aureus
2 strepto
3 pneumcoccus
paho
host bone initiates an infamatory reaction in responce to bacteria.This leads to bone destruction n production of an inflamatory exudate n cels.
Pus spreads in the folowing dir
a)Along the medulary cavity-




pus trickles along the medulary cavity n causes thrombosis of venous n arterial medulary vessls.

B)OUT OF THE CORTEX-
pus travels alog Volkmans canals n lies subpriosteally.Periosteum is lifted off .

C) OTHER DIRECTION-
in joints

DIAGNOSIS-
1 acte onset of pain
2 swelling at the end of bone
3 fever.
Pry focus of infection elsewhere in the body.Child is febrile n dehydrated with redness,heat ,abscess in muscle.

INVESTIN-
1 BLOOD -PMN leucocytosis
ESR incr
Blood Culture

2 X rays periosteal new bone formation.

3 Bone scan - tecnetium99 may incr uptake by bone in metaphysis.

4 Aspiration of bone using thick needle- to cofirm the pus.

DDS
1 ACUTE SEPTIC ARTHITIS

2 A. Rheumatic arhritis

3 SCURVY

4 A. POLIOMYELITIS

TREAT-
1 IF CHILD BROUGHT WITHEN 48 Hrs.
Rest
Cefotoxime100-150mg/kg
Amikacin 15mg/kg
I.V.Given
I.v.fluids.
4 hr temp chart n pulse record.
After 2 wks can b given oral.Then continue for 6wks.

2 CHILD BROUGHT AFTER 48 hrs.-
 A drill hole is made in bone in metaphysis.If pus wells up 4m the drill hole, hole enlarge until free drainage obtained. Swab is taken for culture n sensitivity.
Wound is closed over sterile suction drain.

COMPLICATION-
SEPTICAMIA n PYAEMIA

LOCAL-

1 CHRONINIC OSTEOMYELITIS

2 ACUTE PYOGENIC ARHRITIS

3 PATHOLOGICAL#

4 GROUTH PlATE DISTURBANCE