• Title/Summary/Keyword: 골수염

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$^{99m}Tc-MDP$골스캔을 이용한 초기 골수염의 진단과 이의 평가

  • Lee, Sang-Rae;Kim, Won-Cheol
    • The Journal of the Korean dental association
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    • v.25 no.6 s.217
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    • pp.541-548
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    • 1987
  • 골수염은 조기에 적절한 치료를 하지않으면 중대한 후유증이 초래되므로 신속한 진단과 치료가 요구된다. 골수염을 진단하기 위해서는 구강검진, 방사선검사, 병리조직학적 검사, 혈액 및 세균배양검사와 골스캔등이 필요하다. 골수염의 감염과정은 골에 파괴적 및 재생적 변화의 양자를 모두 일으키지만 X선사진소견에서는 임상증상이 발현된 후 약 10내지 14일이 경과되어야만 골변화를 관찰할 수 있으며 그 이전에는 대체로 비특이적 연조직의 종창만을 보인단. 반면에 골스캔을 이용하면 급성염증기의 골질환을 감견하기가 용이하다. 골스캔제의 국소골섭취의 증가는 골의 어떤 부위에서 대사능이나 혈류가 증가된 경우에 일어나기 때문에, 실제로 임상증상이 발현된 후 24시간정도의 조기에 골스캔상은 양성반응을 보인다. 즉 골의 국소적 병변은 어느정도 신생골 형성과 골파괴가 같이 수반되어있고 이러한 신생골은 골스캔제와 친화력이 강하므로 골형성반응을 야기하는 어떠한 병변이라도 골스캔에 의하여 발견될 수 있다. 임상적으로 골수염에 대하여 골스캔을 시행하는 경우는 골수염의 조기진단, 골수염과 봉와직염과의 감별진단, 만성 공수염의 악화여부 및 치료에 대한 반응을 monitoring하기 위해서 시행된다.

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The Clinical Aspects of Acute Septic Arthritis and Acute Osteomyelitis in Children (소아기 급성 화농성 관절염과 급성 골수염의 임상적 고찰)

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Oh, Phil-Soo;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.149-156
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    • 2005
  • Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

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A Case of Neonatal Osteomyelitis of Thoracic Vertebrae due to MRSA (흉추에 생긴 MRSA에 의한 신생아 골수염 1례)

  • Park, Eun Sook;Shin, Seon Hee;Kim, Sung Goo;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.236-240
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    • 2002
  • Vertebral osteomyelitis represents only 1% to 2% of osteomyelitis and may pose a diagnostic conundrum, with disastrous consequences if diagnosis and therapy are delayed. We report a neonate with the unique association of vertebral osteomyelitis and MRSA infection. A 1-month-old boy was admitted to the hospital for evaluation of high fever and decreased oral intake. He was born at 34 wks, and his birth weight was 1.6 kg. We founded MRSA on his blood culture. Magnetic resonance imaging study showed findings of T7-T8 vertebral osteomyelitis. With 8 weeks of intravenous vancomycin treatment, the patient improved clinically and radiologically.

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Osteomyelitis of Mandibular Condyle : A Case Report in 9-year-old Child (9세 소아에서 발생한 하악과두의 골수염)

  • Lee, Kyung-Eun;Choi, Soon-Jeong;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.34 no.3
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    • pp.333-340
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    • 2009
  • Osteomyelitis means inflammation of the bone marrow. It usually begins in the medullary cavity, involving the cancellous bone; then it extends and spreads to the cortical bone and eventually to the periosteum. The cause is usually thought to be microbiological. But there still are factors that predispose to produce a possible bone infection such as injuries, syphilis, actionomycosis, chronic kidney failure, alcoholism, malnutrition, radiotherapy, and chemotherapy. Treatment of modalities have been directed toward eradicating microbes and improving circulation in the early stage. In the case presented, surgical debridement and IV antibiotics were the treatment of choice. Osteomyelitis in children is mainly affected in the mandible. And in childhood, the mandibular condyle is regarded as an important center of mandibular growth. Therefore, in young patients, osteomyelitis involving this region may cause a restraint of mandibular development, resulting in facial asymmetry. So diagnosis in the early stage is important in child with osteomyelitis. Recently, we have encountered an interesting case of osteomyelitis of the mandibular condyle in 9-year-old boy. So we present the case and review the literature about osteomyelitis.

Arthroscopic Management in Chronic Osteomyelitis (만성 골수염의 내시경적 처치 - 증례 보고 2예 -)

  • Lee Beom Koo;Eom Gi Serk;Ki Yong Chul;Cho Hyun Yee
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.192-194
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    • 2002
  • The goal of surgery of chronic osteomyelitis is removal of dead bone and achieving a viable and vascular environment. During saucerization, the sequestrum could be checked and resected completely. But it can causes vascular injury by massive soft tissue dissection in saucerization of chronic osteomyelitis. Recently, we experienced medulloscopy in the treatment of chronic osteomyelitis and it is possible for us to visualize the sequestrum, to do complete resection of dead bone and to reduce vascular injury during operation.

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Late-Onset Candida Vertebral Osteomyelitis in Two Young Patients Who Underwent Heart Transplant Surgery (심장 이식술을 받은 젊은 환자에서 발생한 2예의 지연성 칸디다 척추 골수염)

  • Kang, Min Seok;Son, In Seok;Kim, Tae Hoon;Lee, Suk Ha
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.72-77
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    • 2019
  • Candida vertebral osteomyelitis (CVO) is a rare disease that is a complication of intravenous drug use, but recently it has been recognized as mostly an opportunistic infection. Because CVO appears to mimic pyogenic spondylodiscitis in terms of the clinical and radiologic presentations, it is often neglected in a usual clinical setting. The clinical, radiological, and biological characteristics of CVO are often used to make a differential diagnosis with vertebral osteomyelitis from other etiologies. Once an initial proper diagnosis was performed, the treatment relies on the prompt initiation of appropriate pharmacotherapy and serial monitoring of the clinical progress. This paper report late-onset CVO in two young patients who underwent a heart transplant surgery and had postoperative systemic candidiasis. These two cases are a good reminder of the potential of CVO in immunosuppressive patients treated with anti-fungal agents. This paper presents these two cases with a review of the relevant literature.

Endoscopic Assisted Treatment of Acute Osteomyelitis with Extensive Subperiosteal Abscess in a Child - A Case Report - (광범위 골막하 농양을 동반한 소아 급성 골수염의 내시경적 치료 - 1예 보고 -)

  • Song, Kyeong-Seop;Jeon, Ho-Seung;Jeon, Seung-Joo;Kim, Hyung-Gyu;Cho, In-Kee
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.199-202
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    • 2006
  • The effects of acute hematogenous osteomyelitis vary with a patient's age because of the differences in the blood supply and structure of the bone. In children older than 2 years of age, this process results in extensive abscess formation when both the endosteal and periosteal blood supply are destroyed. Thorough drainage of abscess cavity and removal of all dead or necrotic material are not always possible although large skin incision is made along the abscess. Authors successfully managed acute osteomyelitis of the tibia with extensive large abscess in a 11 year-old female, using minimal incisions and 4-mm endoscope.

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Detection of Osteomyelitis Using a Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy (Tc-99m 표지 항과립구항체 면역신티그라피를 이용한 골수염의 진단)

  • Kang, Won-Jun;Chung, June-Key;Yeo, Jeong-Seok;Hong, Mee-Kyoung;Jeong, Jae-Min;Lee, Dong-Soo;Lee, Sang-Hoon;Choi, In-Ho;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.344-353
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    • 1998
  • Purpose: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. Materials and Methods: The study population was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 patients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. Results: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. Conclusion: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis.

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