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    Plain X Rays of Bones

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    Emmanuella Noel
    This document discusses osteomyelitis, which is inflammation of bone caused by bacterial infection. Common causative organisms are Staphylococcus aureus and other bacteria. Presentations can be acute, subacute, or chronic. Acute osteomyelitis is classified as hematogenous or exogenous based on route of infection. The disease progresses through stages of inflammation, suppuration, sequestrum formation, involucrum formation, and potential resolution with treatment. Chronic osteomyelitis is a severe, persistent form that can be caused by tuberculosis or syphilis. Plain X-rays can reveal features like bone sclerosis, lucent channels, and periosteal reaction that help with diagnosis.

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    Plain X Rays of Bones

    Uploaded by

    Emmanuella Noel
    83 views17 pages
    This document discusses osteomyelitis, which is inflammation of bone caused by bacterial infection. Common causative organisms are Staphylococcus aureus and other bacteria. Presentations can be acute, subacute, or chronic. Acute osteomyelitis is classified as hematogenous or exogenous based on route of infection. The disease progresses through stages of inflammation, suppuration, sequestrum formation, involucrum formation, and potential resolution with treatment. Chronic osteomyelitis is a severe, persistent form that can be caused by tuberculosis or syphilis. Plain X-rays can reveal features like bone sclerosis, lucent channels, and periosteal reaction that help with diagnosis.

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    This document discusses osteomyelitis, which is inflammation of bone caused by bacterial infection. Common causative organisms are Staphylococcus aureus and other bacteria. Presentations can be acute, subacute, or chronic. Acute osteomyelitis is classified as hematogenous or exogenous based on route of infection. The disease progresses through stages of inflammation, suppuration, sequestrum formation, involucrum formation, and potential resolution with treatment. Chronic osteomyelitis is a severe, persistent form that can be caused by tuberculosis or syphilis. Plain X-rays can reveal features like bone sclerosis, lucent channels, and periosteal reaction that help with diagnosis.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    83 views17 pages

    Plain X Rays of Bones

    Uploaded by

    Emmanuella Noel
    This document discusses osteomyelitis, which is inflammation of bone caused by bacterial infection. Common causative organisms are Staphylococcus aureus and other bacteria. Presentations can be acute, subacute, or chronic. Acute osteomyelitis is classified as hematogenous or exogenous based on route of infection. The disease progresses through stages of inflammation, suppuration, sequestrum formation, involucrum formation, and potential resolution with treatment. Chronic osteomyelitis is a severe, persistent form that can be caused by tuberculosis or syphilis. Plain X-rays can reveal features like bone sclerosis, lucent channels, and periosteal reaction that help with diagnosis.

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    Download as ppt, pdf, or txt
    of 17

    Plain X rays of Bones

    15th Mai 2010


    A patient presents to
    hospital with severe left
    arm pain, malaise and
    fever.

    He was 15 years old

    The DD here are;


    •Cellulitis.
    • Acute suppurative
    arthritis.
    • Acute rheumatism.
    • Sickle cell crisis.
    • Gaucher’s disease

    Acute osteomyelitis
    Osteomyelitis
    Inflammation of bone caused by an infecting organism.

    Commonest cause Staphylococcus spp. (aureus)*


    Other infecting organisms are E coli, S marcescens, and P
    aeruginosa.

    In patients with sickle cell organism like Salmonella species


    and S aureus may be implicated.

    Presentations may be acute, subacute, or chronic.


    On the basis of the route of infection, acute osteomyelitis can be
    classified as hematogenous or exogenous.

    Hematogenous forms are predominantly seen in children and


    normally involves highly vascular bones. (In adults,
    hematogenous forms affects the vertzebral bodies).
    Stages of disease
    The disease process involves 5 stages:
    •Inflammation: inflammation with vascular congestion and
    increased intraosseous pressure. Obstruction to blood
    flow occurs with intravascular thrombosis.
    •Suppuration: Pus within the bones forces its way through
    the haversian system and forms a subperiosteal abscess
    (2-3 days).
    •Sequestrum: Increased pressure, vascular obstruction,
    and infective thrombus compromise the periosteal and
    endosteal blood supply, causing bone necrosis and
    sequestrum formation (7th day).
    •Involucrum: This is new bone formation from the stripped
    surface of periosteum.
    •Resolution : With antibiotics and surgical treatment early
    in the course of disease, may resolves +/- complications.
    Risk Factors:
    •trauma
    •diabetes
    •suppressed immunity; hemodialysis
    •splenectomy
    Abnormal trabeculation & lysis
    within distal tibial metaphysis
    due to periosteal reaction
    Chronic osteomyelitis is
    a severe, persistent,
    form of osteomyelitis
    incapacitating infection
    of bone and bone
    marrow

    Specific forms of chronic osteomyelitis


    •Brodie abscess
    •Tuberculous osteomyelitis
    •Congenital syphilis, and acquired syphilis.
    •A Brodie abscess is a form of chronic
    osteomyelitis that occurs in the absence of
    a preceding episode of acute osteomyelitis.
    The lesion causes a localized abscess
    within the bone, often close to metaphysis.
    •Tuberculous osteomyelitis of the bone is
    secondary to the spread of infection from a
    primary source in the lung or GI tract.

    chronic pyogenic osteomyelitis due to TB


    Xteristic Plain radiographic features of a Brodie abscess
    •A central area of radiolucency with a surrounding thick rim of reactive
    bone sclerosis, which may persist for months.
    •Pathognomonic tortuous parallel lucent channels extending toward the
    growth plate.
    •A variable degree of periosteal new-bone formation.
    •Associated soft tissue swelling.
    A 30-year-old man underwent internal fixation to his ulna
    fracture and now has features of toxaemia.

    Marked extensive subcutaneous emphysema involving the


    entire forearm.
    Anaerobic infection
    DD
    Anaerobic cellulitis.
    Gas gangrene by myonecrosis

    Commonest cause is the


    •Clostridium perfingens

    Other causes may be


    •Staphylococcus aureus
    •Streptococcus pyogenes

    Diagnosis of cellulitis is usually


    clinical.
    Palpation crepitations may be
    felt over the swollen area.
    US appearance resembles oedema of subcutaneous
    fat, increased echogenicity of the subcutaneous fat with
    decreased acoustic transmission, blurring of tissue
    planes, progressing to hypoechoic strands between
    hyperechoic fatty lobules.
    This appearance is non specific & can not be
    differentiated from subcutaneous oedema
    A young man who
    sustained injury from an
    automobile accident.

    2-part anatomic neck fracture


    (Neel´s classification)
    Humerus fracture – proximal (Neel´s classification)
    May occur due to fall onto the outstretched hand
    3-part surgical
    neck and greater
    trochanter fracture
    4-part fracture proximal
    humeral fracture with
    head split.
    Blood supply was
    distrupeted here
    Thank you

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