Osteomyelitis

1
Osteomyelitis

• Inflammation with an Infectious cause.
• Osteomyelitis affects the bones septic arthritis
  affects the joints.

2
Etiology Osteomyelitis

• Hematogenous
• Secondary to adjacent infection
• Direct inoculation
• Vascular insufficiency

Primary agents causing osteomyelitis staph,
strep, gonorrhea
3
Septic Arthritis

• Etiology
• Hematogenous
• Direct inoculation
• Agents
• staph, strep, gonorrhea, viral, post rubella

4
Development of Osteomyelitis
Classification of osteomyelitis Acute
Chronic
Sinus tracts form, bone destruction
5
Development of Osteomyelitis

• 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

6
Osteomyelitis

• Diagnostic tests
• X-ray, no initial bone changes
• CT, MRI. biopsy
• Culture
• Late bone changes with bone destruction

• Signs and symptoms
• Acute 24-48 hrs post-surgery
• Pain
• Swelling, erythemia
• Pseudoarthrosis
• Chronic

7
Septic Arthritis

• Signs and symptoms
• Painful
• Loss of motion
• High fever
• Less likely to become chronic

• Diagnostic tests
• Lab studies
• X-rays show synovial effusion
• Arthrocenthesis with culture

8
Synovial inflammation!
Comparison acute rheumatoid arthritis and septic
arthritis of the joint!
Purulent exudate!
9
Management

• Interventions
• Acute prevent, identify source, short-term
  antibiotics
• Chronic opt nutrition, splint for support,
  surgery,hyperbaric O2, muscle flap, long term
  antibiotics

• Nursing Diagnosis
• Alteration in comfort
• Potential for injury fracture
• Hyperthemia
• Knowledge deficit

10
If only I had taken those antibiotics!
Avoid the pain and grief of chronic
osteomyelitis!
11
Tuberculosis of Bone and Spine

• Source
• Signs and symptoms vertebral collapse, pain,
  deformity (Potts fx), systemic as night sweats,
  anemia
• Diagnosis
• Treatment

12
Test Yourself!

• 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.