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Ebook Bone and joint imaging (3rd edition): Part 2

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Nội dung chi tiết: Ebook Bone and joint imaging (3rd edition): Part 2

Ebook Bone and joint imaging (3rd edition): Part 2

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2nderstanding of regional anatomy is fundamental to the accurate interpretation of clinical, radiographic, and pathologic characteristics of infections

of hone, joint, and soft tissue. In most persons with such infections, a specific mechanism of contamination can be recognized; infection may be deri Ebook Bone and joint imaging (3rd edition): Part 2

ved from hematogenous seeding, spread from a contiguous source, direct implantation, or operative contamination. The radiographic findings of osteomye

Ebook Bone and joint imaging (3rd edition): Part 2

litis (including abscess, involucruin. and sequestration), septic arthritis (including joint space loss and marginal and central osseous erosions), an

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2set of infection. Other diagnostic techniques, including scintigraphy and magnetic resonance imaging, allow an accurate diagnosis at an earlier stage

of the process.INTRODUCTIONInfection of bone, joint, and soft tissue is a common and disturbing problem that often represents a diagnostic and therape Ebook Bone and joint imaging (3rd edition): Part 2

utic challenge. Early diagnosis is imperative because it allows prompt treatment, which can prevent many of the dreaded complications.TERMINOLOGYOstcm

Ebook Bone and joint imaging (3rd edition): Part 2

yehtts implies an infection of bone and marrow. It most commonly results from bacterial infections, although fungi, parasites, and viruses can infect

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2menon or, more frequently, as a concomitant to osteomyelitis.Infective (suppurative) periostitis implies contamination of the periosteal cloak that su

rrounds the bone. In this situation, a subperiosteal accumulation of organisms frequently leads to infective osteitis and osteomyelitis.Soft tissue in Ebook Bone and joint imaging (3rd edition): Part 2

fraion indicates contamination of cutaneous, subcutaneous, muscular, fascial, tendinous, ligamentous, or bursal structures. 'Illis may be seen as an i

Ebook Bone and joint imaging (3rd edition): Part 2

solated condition or as a complication of periosteal, osseous, marrow, or articular infection.Articular infection implies a septic process of the join

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2tis or soft tissue infection.A sequestrum represents a segment of necrotic bone that is separated from living bone by granulation tissue. Sequestra ma

y reside in the marrow for protracted periods, harboring living organisms that have the capability of evoking an acute flare-up of the infection.An in Ebook Bone and joint imaging (3rd edition): Part 2

volucrttm denotes a layer of living bone that has formed about the dead bone. It can surround and eventually merge with the parent bone.Cloaca is an o

Ebook Bone and joint imaging (3rd edition): Part 2

pening in the involucrum through which granulation tissue and sequestra can be discharged.Sinuses arc tracts leading to the skin surface from the bone

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2represents a site of active infection. it is lined by granulation tissue and frequently is surrounded by eburnated bone.Gamf'ssclerosing osteomyelitis

is a sclerotic, nonpurulent form of osteomyelitis. Although this term is applied carelessly to any form of osteomyelitis with severe osseous ebumario Ebook Bone and joint imaging (3rd edition): Part 2

n, it should l>c reserved for those cases in which intense proliferation of the periosteum leads to bony deposition and in which no necrosis or purule

Ebook Bone and joint imaging (3rd edition): Part 2

nt exudate and little granulation tissue arc present.The clinical stages of osteomyelitis arc frequently designated acute, subacute, and chronic. 'Ill

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2each of these phases. The relatively abrupt onset of clinical symptoms and signs during the initial stage of infection is a clear indication of the ac

ute osteomyelitic phase; if this acute phase passes without complete elimination of infection, subacute or chronic osteomyelitis can become apparent. Ebook Bone and joint imaging (3rd edition): Part 2

'H1C transition from acute to subacute and chronic osteomyelitis may indicate that therapeutic measures have been inadequate.OSTEOMYELITISRoutes of Co

Ebook Bone and joint imaging (3rd edition): Part 2

ntaminationOsseous (and articular) structures can be contaminated by four principal routes:1Hematogenous spread of infection. Infection can reach the

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2aminated site, Cutaneous, sinus, and dental infections are three important sources ofextraskeletal infective foci.71J714Section XIV Infectious Disease

s3Dina rmplantation. Direct implantation of infectious material into the bone (or joint) may occur following puncture or penetrating injuries.4Postope Ebook Bone and joint imaging (3rd edition): Part 2

rative infection. Postoperative infection may occur via direct implantation, spread from a contiguous septic focus, or hematogenous contamination of t

Ebook Bone and joint imaging (3rd edition): Part 2

he bone (or joint).Hematogenous InfectionBacteremiaBacteria usually enter the blood vessels (or the lymphatics and then the blood vessels) by direct e

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2 tissue; and other structures. In some instances, no primary source of infection is identifiable. Bacteremia is often transient and totally asymptomat

ic; however, in some cases, prominent clinical manifestations may occur.A single pathogenic organism is usually responsible for hematogenous osteomyel Ebook Bone and joint imaging (3rd edition): Part 2

itis. In neonates and infants, Staphylococcus aureus, group B streptococcus, and Escherichia coir arc the bone isolates recovered most frequently. In

Ebook Bone and joint imaging (3rd edition): Part 2

children older than I year of age, s. aureus, Streptococcus pyogenes, and Haemophilus influenzae arc responsible for most cases of hematogenous osteom

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2ae decreaises. Gram-negative organisms assume importance as pathogens in bone and joint infections in adults and in intravenous drug abusers. A recent

surgical procedure or concurrent soft tissue infection is frequently associated with staphylococcal septicemia and osteomyelitis; disorders of the ga Ebook Bone and joint imaging (3rd edition): Part 2

strointestinal or genitourinary tract may initiate a grain-negative septicemia; and an acute or chronic respiratory infection is important in the path

Ebook Bone and joint imaging (3rd edition): Part 2

ogenesis of tuberculous, fungal, and pneumococcal osteomyelitis. Blood cultures are positive in approximately 50% of patients with acute hematogenous

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2inflammation, although this presentation is not uniform. Indeed, as many as 50% of children have vague complaints, including local pain of I to 3 mont

hs’ duration with minimal if any temperature elevation. In infants, hematogenous osteomyelitis often leads to less dramatic findings, including pain, Ebook Bone and joint imaging (3rd edition): Part 2

swelling, and an unwillingness to move the affected bones.The adult form of hematogenous osteomyelitis may have a more insidious onset, with a relativ

Ebook Bone and joint imaging (3rd edition): Part 2

ely longer period between the appearance of symptoms and signs and accurate diagnosis. In all age groups, the prior administration of antibiotics for

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

Ebook Bone and joint imaging (3rd edition): Part 2 infected; involvement of multiple osseous sites appears to be particularly common in infants. In theyounger age group, the long tubular bones of the

extremities arc especially vulnerable; in adults, hematogenous osteomyelitis is encountered more frequently in the axial skeleton. Ebook Bone and joint imaging (3rd edition): Part 2

Infectious DiseasesCHAPTER 53Osteomyelitis, Septic Arthritis, and Soft Tissue Infection: Mechanisms and SituationsSUMMARY OF KEY FEATURESA thorough un

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