• Title/Summary/Keyword: osteomyelitis

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Risk factors affecting amputation in diabetic foot

  • Lee, Jun Ho;Yoon, Ji Sung;Lee, Hyoung Woo;Won, Kyu Chang;Moon, Jun Sung;Chung, Seung Min;Lee, Yin Young
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.314-320
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    • 2020
  • Background: A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU). Methods: The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery. Results: Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561-10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087-5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981-0.999), ulcer size (HR, 1.247; 95% CI, 1.107-1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224-0.73) were associated with risk of amputation. Conclusion: Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.

Fungal Osteomyelitis of Temporomandibular Joint and Skull Base Caused by Chronic Otitis Media

  • Kim, Bok Eum;Park, Keun Jeong;Lee, Jung Eun;Park, YounJung;Kwon, Jeong-Seung;Kim, Seong-Taek;Choi, Jong-Hoon;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.45 no.1
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    • pp.12-16
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    • 2020
  • Chronic otitis media (COM) is a chronic inflammatory disease which affects the middle ear, mastoid cavity. It presents hearing loss, ear pain, dizziness, headache, temporomandibular joint (TMJ) inflammation and intracranial complication. Intracranial complications such as skull base osteomyelitis (SBO) may occur secondary to COM due to transmission of infection by a number of possible routes. SBO is an uncommon condition with a significant morbidity and mortality if not treated in the early stages. We report a-67-year-old male patient with diabetes and untreated COM who presented atypical severe TMJ, periorbital and postmandibular pain. By computerized tomography (CT), magnetic resonance imaging (MRI) and whole body bone scan (WBBS), he was diagnosed with SBO spreading from untreated COM via infective arthritis of TMJ. Through this case, we suggest proper utilization of diagnostic imaging, especially CT or MRI for the early detection of SBO in the case of COM accompanying with the greater risk of infection developments such as diabetes.

Clinical and panoramic radiographic features of osteomyelitis of the jaw: A comparison between antiresorptive medication-related and medication-unrelated conditions

  • Shin, Jeong Won;Kim, Jo-Eun;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Lee, Sam-Sun;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.49 no.4
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    • pp.287-294
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    • 2019
  • Purpose: This study was performed to analyze the clinical and imaging features of contemporary osteomyelitis(OM) and to investigate differences in these features on panoramic radiography according to patients' history of use of medication affecting bone metabolism. Materials and Methods: The records of 364 patients(241 female and 123 male, average age 66.8±14.9 years) with OM were retrospectively reviewed. Panoramic imaging features were analyzed and compared between patients with medication-related OM(m-OM) and those with conventional, medication-unrelated OM(c-OM). Results: The age of onset of OM tended to be high, with the largest number of patients experiencing onset in their 70s. The 2 most frequent presumed causes were antiresorptive medication use (44.2%) and odontogenic origin (34.6%). On panoramic radiographs, a mix of osteolysis and sclerosis was the most common lesion pattern observed (68.6%). Sequestrum, extraction socket, and periosteal new bone formation were found in 143(42.1%), 79 (23.2%), and 24 (7.1%) cases, respectively. The m-OM group exhibited sequestrum and extraction socket more frequently and displayed significantly higher mandibular cortical index values than the c-OM group. Conclusion: We observed some differences in imaging features as shown on panoramic radiography according to the history of antiresorptive medication use. This study may help elucidate the predictive imaging features of medication-related osteonecrosis of the jaw.

OSTEOMYELITIS OCCURRING LEUKEMIA PATIENT: A CASE REPORT (백혈병 환자에서 발생한 골수염 : 증례보고)

  • Kim, Bong-Gyun;Kim, Su-Gwan;Yeo, Hwan-Ho;Kim, Sang-Ryol
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.3
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    • pp.310-312
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    • 2000
  • Leukemia is a malignancy caused by precursor cells of white blood cell. It is a malignant tumor of hematopoietic organs, characterized by the disorder of hematopoietic function due to the proliferation of immature bone marrow cells or lymphatic cells and by abnormal tissue infiltration of leukemic cells. The major signs of leukemia are caused by the failure of bone marrow function. As the number of red blood cells decreases, anemia is to appear. The number of white blood cells in leukemia is usually increased but immature white blood cells circulating the body has little defense ability, thus become susceptible to infection. 27 year-old female patient who was treated chemotherapy and bone marrow transplantation after diagnosed as chronic myelogenous leukemia(CML) was diagnosed as osteomyelitis in mandible after clinical and dental radiographic film examination. Because of the result of examination, the involved tooth of the patient was extracted accompanied by sequestrectomy and saucerization under general anesthesia. After the patient had long term medication of antibiotics, the lesion was healed. Therefore. author, et al. report this case with literature review.

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AN IMMUNOHISTOCHEMICAL STUDY ON CALCIFYING TISSUES OF THE FLORID CEMENTO-OSSEOUS DYSPLASIA EASILY INVOLVING CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS (만성 미만성 경화성 골수염을 동반한 개화성 백악질-골 이형성증의 면역조직화학적 연구)

  • Kim, Ji-Hyuck;Jo, Joung-Ae;Kim, Soung-Min;Park, Young-Wook;Huh, Jin-Young;Lee, Suk-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.293-297
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    • 2003
  • Florid cemento-osseous dysplasia (FCOD) is a benign, non-neoplastic lesion characterized by multiple sclerosing masses only within jawbones. It is frequently confused with chronic diffuse sclerosing osteomyelitis (CDSO) in previous literatures. In our study, two cases of FCOD were examined to know the characteristics of their calcifying tissues. The first case was non-infected, while the second case was severely infected, displaying the typical features of CDSO in clinico-radiologic findings. The infected FCOD case showed a lot of bacterial colonies in the main lesion with relatively rare inflammatory reaction. The globular cementum-like materials of FCOD showed woven bone pattern and was positive for Alcian blue stain, and also positive for the antibodies of ameloblastin, bone morphogenetic protein (BMP) -2 and -4. On the other hands, in the immunostains of matrix metalloproteinase (MMP) -3, -9, -10, and $TNF-{\alpha}$, macrophage infiltrated in the FCOD lesion was rarely observed. These data suggest that the cementum-like materials of FCOD contain various matrix proteins, and that the cementum-like materials are relevant to the overgrowth of the bacterial colonies by inhibition of the regional inflammatory reactions.