• Title/Summary/Keyword: 만성 골수염

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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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$^{99m}Tc-MDP$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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Chronic Recurrent Multifocal Osteomyelitis of The Shoulder - A Case Report - (견관절에 발생한 만성 재발성 다발성 골수염 - 1예 보고 -)

  • Lee, Ki-Won;Choi, Young-Joon;Ahn, Hyung-Sun;Kim, Chung-Hwan;Hwang, Jae-Kwang;Kang, Jeong-Ho;Lee, Seon-Woo;Cho, Wan-Jong;Park, Jun-Seok
    • Clinics in Shoulder and Elbow
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    • v.14 no.2
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    • pp.248-252
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    • 2011
  • Purpose: We report a case of chronic recurrent multifocal osteomyelitis of the shoulder. Materials and Methods: A 16 year-old male who had suffered from chronic recurrent multifocal osteomyelitis of the shoulder was diagnosed by clinical features and biopsy and was treated with arthroscopic debridement and Naproxen. Results: Symptoms was subsided without relapse during 16 months follow up. Conclusion: Chronic recurrent multifocal osteomyelitis is rare disease and it can be misdiagnosis because of its rarity and non-specific clinical presentation. This is a report of a case of chronic recurrent multifocal osteomyelitis of the shoulder in 16 years man.

Free Muscle Transplantation of the Chronic Lower Extremity Osteomyelitis (만성 하지 골수염에 시행한 유리 근 이식술)

  • Lee, Jun-Mo;Huh, Dal-Young
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.176-183
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    • 1999
  • Chronic osteomyelitis have been treated with wound dressing and antibiotics therapy often results in healing but foul odor pus discharges from the fibrotic soft tissues reactivates and requires appropriate control of the infection. Debridement of the wound, curettage and sequestrectomy, bone graft and immediate free flap transplantation is the curative protocol for the chronic osteomyelitis in the lower extremity. Authors have treated 7 cases of chronic osteomyelitis in the lower extremity with microsurgical free tissue transplantation at Department of Orthopedic Surgery, Chonbuk National University Hospital from December 1993 through February 1998. The results are as follows. 1. The chronic osteomyelitis occurred in tibial shaft in 4 cases, in calcaneus 2 cases and in femur 1 case. 2. Duration of the chronic osteomyelitis was at average 31.6 years. 3. Squamous cell carcinoma in the surrounding fibrotic tissue was biopsied in 1 case. 4. 4 cases had no trauma and occurred through hematogenous infection and 3 cases had fracture trauma. 5. Wound debridement and immediate free muscle transplantation had done in 5 cases and wound debridement, sequestrectomy and immediate free muscle transplantation in 2 cases. 6. Rectus abdominis muscle transplantation had peformed in 4 cases(57.1%), latissimus dorsi mucle 1 case(14.3%), latissimus dorsi myocutaneous 1 case(14.3%) and gracilis 1 case (14.3%). 6 cases of 7 were success(85.7%). 7. 1 case of failed latissimus dorsi musculocutaneous flap in thigh had done above knee amputation and 1 case of chronic posttraumatic osteoarthritis of the ankle joint had done below knee amputation at other hospital.

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THE FLORID OSSEOUS DYSPLASIA OF THE JAWS (악골에 발생한 Florid Osseous Dysplasia의 방사선학적 연구)

  • Park Tae Won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.19 no.1
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    • pp.19-22
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    • 1989
  • Three cases of florid osseous dysplasia of the jaw were investigated. Radiographs showed sclerotic. globular and ground glass opacities throughout the jaws. Two cases were asymptomatic but one case failed to heal following extraction of the mandibular molar and infection complicated the disease. These cases appear to represent the most exuberant manifestations of this reactive benign fibro-osseous lesion of the jaws.

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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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Osteomyelitis involved in Mandibular Condyle (하악 과두에 이환된 악골 골수염)

  • Park, Ju-Hyun;Kwon, Jeong-Seung;Ahn, Hyung-Joon;Kim, Seong-Taek;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.383-386
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    • 2008
  • Osteomyelitis is considered an inflammatory condition of bone that usually begins as an infection of the medullary cavity and quickly extends to periosteum of the area. Early acute osteomyelitis of the mandible is usually characterized by deep, intense pain, high intermittent fever, paresthesia or anesthesia of the lower lip and a clearly identifiable cause. If the disease is not controlled or inadequately treated after onset, acute osteomyelitis progresses to a chronic form. The diagnosis of mandibular osteomyelitis rests on processing for identification of microbiologic isolates and on imaging studies to determine the extent of disease. Mandibular osteomyelitis often is associated with involvement of the masticator space and can exhibit symtoms similar to temporomandibular disorder including orofacial pain and limited mouth opening. Advanced imaging modalities can be helpful in obtaining a proper diagnosis.

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.