Osteomyelitis in Children

Osteomyelitis in Children - Osteomyelitis in Children Dr....

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Osteomyelitis in Children Dr. Robert Deane Janeway
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Outline Age Incidence Etiology Pathophysiology Presentation Laboratory investigations Imaging Treatment Surgery Complications Summary Special Groups
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Age / Incidence / Etiology 1/1000 – 1/ 20 000 Male > Female Pre antibiotic era ……20-50% mortality
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Age / Incidence / Etiology Advances in treatment Earlier dx Antibiotic tx Surgery less delay Children better nourished
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Age / Incidence / Etiology Glasgow incidence decreased New Zealand……. Madri > Whites South Africa……. . Black > Whites Changing disease / Changing organism Seasonal Variation Nutritional status, climate, lifestyle
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Age / Incidence / Etiology H Flu Big cause 1970’s 1-4 yrs Now decreased due to vaccinations Kingella Kingae OM in older kids Septic Arthritis 1-3 yrs Neonates separate group
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Pathophysiology Poorly defined Direct inoculation Hematogenous spread Local invasion
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Pathophysiology Infection Starts in Metaphysis Arteriole Loop / Venous Lakes Spread via Volkman’s canal / Haversian system Endothelium Leaks
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Pathophysiology Few phagocytes in Zone of Hypertrophy Highest incidence in fastest growing bone Tubular > Flat bones
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Pathophysiology Gaps in endothelium metaphyseal vessel Bacteria pass Adhere to Type 1 collagen Increase pressure in bone/ decrease blood flow Bone infarction / Dead Bone (sequestrum)
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Osteomyelitis in Children - Osteomyelitis in Children Dr....

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