Transcript Amputations osteolyeliis

Osteomyelitis
Inflammation with an Infectious
cause.
Osteomyelitis affects the bones;
septic arthritis affects the joints.
Etiology Osteomyelitis
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Hematogenous
Secondary to
adjacent
infection
Direct
inoculation
Vascular
Primary agents causing
insufficiency osteomyelitis: staph,
strep, gonorrhea
Septic Arthritis
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Etiology
– Hematogenous
– Direct
inoculation
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Agents
– staph, strep,
gonorrhea, viral,
post rubella
Development of Osteomyelitis
Classification of osteomyelitis
Acute
Chronic
Sinus tracts form,
bone destruction
Development of Osteomyelitis
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Bacteria invade bone
Pressure within bone
increases
Periosteum elevates and
bone DIES
Infected bone separates
= sequestrum
Separated periosteum
produces new bone =
involcrum
Sinus tract forms
Osteomyelitis
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Signs and
symptoms
– Acute 24-48 hrs
post-surgery
– Pain
– Swelling,
erythemia
– Pseudoarthrosis
– Chronic
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Diagnostic tests
– X-ray, no initial
bone changes
– CT, MRI. biopsy
– Culture
– Late bone
changes with
bone
destruction
Septic Arthritis
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Signs and
symptoms
– Painful
– Loss of motion
– High fever
– Less likely to
become chronic
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Diagnostic tests
– Lab studies
– X-rays show
synovial
effusion
– Arthrocenthesis
with culture
Synovial
inflammation!
Comparison acute
rheumatoid arthritis
and septic arthritis of
the joint!
Purulent
exudate!
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Management
Interventions
– Acute: prevent,
identify source,
short-term
 Nursing
antibiotics
Diagnosis
– Chronic: opt
– Alteration in
nutrition, splint for
comfort
support,
– Potential for injury:
surgery,hyperbaric
fracture
O2, muscle flap,
– Hyperthemia
long term
– Knowledge deficit
antibiotics
If only I had taken
those antibiotics!
Avoid the pain
and grief of
chronic
osteomyelitis!
Tuberculosis of Bone and Spine
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Source
Signs and symptoms: vertebral
collapse, pain, deformity (Potts fx),
systemic as night sweats, anemia
Diagnosis
Treatment
Test Yourself!
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Sixty days following her TKR, Ms. K calls
her physician to report “a little pain and
swelling “ around her knee. What advice
would you give her?
– a. “That is expected.”
– b. “Wait and see what happens.”
– c. “Let me check the knee.”
– d. “You may need an antibiotic.”