小结
定义
病史和体格检查
关键诊断因素
- 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
其他诊断因素
- 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
危险因素
- 穿透伤
- 手术污染
- 静脉注射药物滥用
- 糖尿病
- 牙周炎
诊断性检查
首要检查
- 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
需考虑的检查
- 超声
- 骨骼 MRI
- CT 扫描
- 放射性核素扫描
- 组织学
治疗流程
急性骨髓炎
慢性骨髓炎
撰稿人
作者
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
利益声明
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
利益声明
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
利益声明
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
利益声明
MM received a research grant in 2013 from Bonesupport AB, Lund, Sweden to collect data for a study on antibiotic carriers in osteomyelitis treatment.
鸣谢
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
更多 鉴别诊断指南
- 英国微生物学研究标准：骨髓炎相关的骨和软组织研究
- 诊断和治疗成人自发性脊椎骨髓炎的临床实践指南
更多 指南患者教育信息
Osteomyelitis
更多 患者教育信息
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