Osteomyelitis

Definition: Infection of the bone and surrounding tissues, most commonly caused by
Staphylococcus Aureus.
> It can be either acute or chronic.
>This disorder usually occurs
as a result of an infection in one part of the body that is transported through the
bloodstream to a bone in a distant location.
Also Known As:
Hematogenous Osteomyelitis
Incedence

Osteomyelitis affects about 2 in 10,000 people.

Acute osteomyelitis is rare in children. It's estimated that one in every 1,000
children under the age of one will develop acute osteomyelitis.

The condition is even less common in children over one, with one in every 5,000
children affected

Risk Factors
• Trauma
• Diabetes
• Hemodialysis
• Splenectomy
• ↓Immune function
• Poor circulation

Anatomy
Pathophysiology
Osteomyelitis

Risk Factors
Trauma
Diabetes
Hemodialysis
↓Immune function
Poor circulation

Bacterial invasion
Staphylococcus Aureus(70% and 80%)
Proteus, Pseudomonas
Escherichia coli

Compensatory Mechanisms
Molecular changes
Pus spread to vascular channel
Decreased blood flow
exudation of polymorphonuclear leukocytes
increased erythrocytes
increased WBC
Anatomical Physical Changes:

Vascular congestion
Small vessel thrombosis
Edema
Inflammation

Manifestation on Effect on Bodily Function:

↓ cardiac output
↓ impaired cellular metabolism
ischemic necrosis
systemic infection
lysis of the bone cell

Clinical Manifestations ( S/S ) :

Drainage of pus through the skin
Pain and/or tenderness in the infected area
Swelling and warmth in the infected area
Fever
Nausea, secondarily from being ill with infection

Bone deformities
 Diagnostic Findings
 x-ray findings
- demonstrate soft tissue swelling
- bone necrosis
- and new bone information are evident
 Radioisotope bone scans , Isotope-labeled white blood cell (WBC) scan,
Magnetic Resonance Imaging
 Help with early definitive diagnosis
 Wound and blood culture
 Performed to identify appropriate antibiotic therapy

Management

Medical management for clients with Osteomyelitis are as follows:

 Analgesics as prescribed.
 Antibiotics as prescribes.
 Dressing changes- use sterile technique.
 Maintain proper body alignment and change position frequently to prevent deformities.
 Immobilization of affected part.

Surgery if needed:

 Incision ad Drainage of bone abscess.

 Sequestrectomy- removal of dead, infected bone and cartilage.
 Bone grafting is recommended after repeated infections.