Transcript INFECTIONS: ORTHOPEDICS

X RAYS OF INFECTIOUS BONE
DISEASES
CONTENTS
 X RAYS OF INFECTIONS OF BONES
 SUMMARY
X RAYS OF INFECTIONS OF BONES
OSTEOMYELITIS
 Osteomyelitis refers to inflammation of bone that is almost
always due to infection, typically bacterial.
 Other non-pyogenic causes of osteomyelitis are discussed
separately:
 Tuberculous osteomyelitis
 Skeletal syphilis
 Fungal osteomyelitis
 Osteomyelitis can occur at any age.
 In those without specific risk factors, it is particularly
common between the ages of 2-12 years of age and is more
common in males (M:F of 3:1).
 The diagnostic imaging of osteomyelitis can require the
combination of diverse imaging techniques for an accurate
diagnosis.
 Conventional radiography should always be the first imaging
modality to start with, as it provides an overview of the
anatomy and the pathologic conditions of the bone and soft
tissues of the region of interest.
X-RAY
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884903/
CASE 1
12 YEAR OLD WITH OSTEOMYELITIS OF THE DISTAL
RADIUS, WITH FOLLOWUP X-RAYS AT 1 MONTH, 6 MONTHS
AND 4 YEARS DEMONSTRATING COMPLETE RESOLUTION.
http://radiopaedia.org/cases/osteomyelitis-distal-radius
CASE 2
NEONATE CIRCUMCISED SINCE 25 DAYS. NOTE THE RIGHT
UPPER MEDIAL TIBIAL METAPHYSEAL LYTIC LESION; THICK
PERIOSTITIS AND INTERRUPTED SOFT TISSUES AROUND.
http://radiopaedia.org/articles
BRODIE ABCESS
 Brodie abscess refers to an intraosseous abscess related to focus of
subacute pyogenic osteomyelitis.
 Unfortunately, there is no reliable way radiographically to exclude
a focus of osteomyelitis.
 It has a protean radiographic appearance and can occur at any
location and in a patient of any age.
 It might or might not be expansile, have a sclerotic or nonsclerotic
border, or have associated periostitis.
http://radiopaedia.org/articles
BRODIE ABSCESS IN THE PROXIMAL
TIBIA
PATIENT 15 YEARS OF AGE WITH PAIN AND SWELLING IN HIS
RIGHT KNEE OF SEVERAL WEEKS OF EVOLUTION.
http://radiopaedia.org/articles
BONE TUBERCULOSIS
 When tuberculosis involves a patient's skeleton, it is the
involvement of his joints that matters most his spine, hips, knees,
feet, elbows, wrists, and shoulders, in this order of frequency, and
occasionally his other joints also.
 Bacilli reach his joints from some focus elsewhere.
 So there are lesions in his lungs, and for signs of surgical
tuberculosis in other parts of his body.
 Look particularly for enlargement of his lymph nodes.
http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x10416.html
http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x10416.html
http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x10416.html
http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x10416.html
POTTS DISEASE
60 YEAR OLD FEMALE PRESENTED WITH VAGUE BACKACHE.
………thank you