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| 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
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