Summary
Definition
History and exam
Key diagnostic factors
- 感染部位的非特异性疼痛
- 不适感和疲劳
- 局部炎症、红斑或肿胀
- 低热
- 存在的危险因素
Other diagnostic factors
- 伤口引流
- 瘢痕、既往皮瓣移植
- 活动范围缩小
- 糖尿病足溃疡时感觉能力减弱
- 尿路症状
- 斜颈
- 肢体畸形
- 叩诊压痛
Risk factors
- 穿透伤
- 手术污染
- 静脉注射药物滥用
- 糖尿病
- 牙周炎
Diagnostic investigations
1st investigations to order
- 白细胞计数
- 红细胞沉降率 (ESR)
- C 反应蛋白 (CRP)
- 受累部位的 X 线平片
Investigations to consider
- 超声
- 骨骼 MRI
- CT 扫描
- 放射性核素扫描
- 组织学
Treatment algorithm
急性骨髓炎
慢性骨髓炎
Contributors
Authors
Jamie Ferguson, MB ChB (hons), MEd., FRCS (Orth)
Senior Clinical Fellow in Limb Reconstruction
The Bone Infection Unit
Nuffield Orthopaedic Centre
Oxford University Hospitals Foundation NHS Trust
Oxford
UK
Disclosures
JF received a research grant in 2013 from Bonesupport AB, Lund, Sweden to collect data for a study on antibiotic carriers in osteomyelitis treatment.
Tse Hua Nicholas Wong, BSc, MB BS, DPhil, MRCP, FRCPath
Consultant in Infectious Diseases and Microbiology
Buckinghamshire Healthcare NHS Trust
Aylesbury
UK
Disclosures
THNW declares that he has no competing interests.
Bridget L. Atkins, MA, MBBS, MSc, FRCPath, FRCP
Consultant
Infectious Diseases, Microbiology and Bone Infection
Oxford University Hospitals NHS Foundation Trust
Oxford
UK
Disclosures
BLA declares that she has no competing interests.
Martin McNally, MB, BCh, MD, FRCSEd, FRCS(Orth)
Consultant in Limb Reconstruction
The Bone Infection Unit
Nuffield Orthopaedic Centre
Oxford University Hospitals Foundation NHS Trust
Oxford
UK
Disclosures
MM received a research grant in 2013 from Bonesupport AB, Lund, Sweden to collect data for a study on antibiotic carriers in osteomyelitis treatment.
Acknowledgements
Dr Jamie Ferguson, Dr Tse Hua Nicholas Wong, Dr Bridget L. Atkins, and Dr Martin McNally wish to gratefully acknowledge Dr Jason H. Calhoun, Dr Nalini Rao, and Dr M. M. Manring, previous contributors to this topic. JHC, NR, and MMM declare that they have no competing interests.
同行评议者
Kristine Johnson, MD
Assistant Professor
Infectious Diseases
Bayview Medical Center
Baltimore
MD
利益声明
KJ declares that she has no competing interests.
Silvano Esposito, MD
Associate Professor
Department of Infectious Diseases
University of Naples
Naples
Italy
利益声明
SE has been reimbursed for attending several conferences and received fees for speaking and running educational programs by Pfizer, Novartis, Wyeth Lederle, Sanofi Aventis, and GSK.
Edward Pesanti, MD
Professor of Medicine
Infectious Diseases Division
University of Connecticut Health Center
Hartford
CT
利益声明
EP declares that he has no competing interests.
鉴别诊断
- 骨转移癌或骨肉瘤
- 陈旧性外伤或新外伤
- 非感染性骨不连
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