Fig. 14.1 Acute Charcot arthropathy. Note severe swelling and erythema which is difficult to differentiate from acute infection 1. Isolated Charcot arthropathy 2. Charcot arthropathy with noninfected ulceration …
Fig. 7.1 Graphic representation of vascular anatomy of the metaphysis of a tubular bone. Bacteria enter the nutrient artery and lodge into the venous sinusoids Terminal arterioles lead to venous…
Bone biopsy typically involves histopathologic evaluation and microbiologic culture. This two-tiered biopsy approach improves accuracy; however, the results are subjected to variable interpretation leading to clinical uncertainty. Diagnostic accuracy is…
Fig. 9.1 Clinical appearance of ankle joint sepsis The clinical appearance of a septic right ankle and the contralateral unaffected limb are seen. The classical clinical presentation consists of a…
Classification systems Cierny-Mader staging system for osteomyelitis Stage 1: Medullary osteomyelitis A Host: healthy Stage 2: superficial osteomyelitis B Host: Bs: Systemic compromise Bl: Local compromise Bls: Local and…
Fig. 10.1 A 70-y/o male with significant peripheral vascular disease with distal ischemia who presented after revascularization with ankle osteomyelitis. (a, b) X-ray imaging shows diffuse osteopenic changes with nonspecific…
Joint replacement (%) All fractures (%) Staphylococcus aureus 12–23 30 Coagulase Negative Staphylococcus 30–43 22 Gram Negative Bacilli 3–6 10 Anaerobes 2–4 5 Enterococci 3–7 3 Streptococci 9–10 1…
Reference Classification Overview [5], see Table 1.2 “Waldvogel” • Mechanism – Hematogenous – Contiguous – Vascular compromise • Duration – Acute – Chronic [33], see Table 1.3 “Cierny-Mader” • Anatomic – Medullary – Superficial – Localized – Diffuse • Physiologic – Normal host – Compromised…
Advantages Disadvantages Avoids surgical procedure Increases risk of infection recurrence Potentially avoids hospitalization Risk of re-ulceration if uncorrected foot deformity Preserves more of foot Antibiotic-related toxicities May shorten duration of…
Fig. 32.1 Schematic drawing of the course of the axillary nerve after the quadrilateral space . Branches A anterior deltoid , M middle deltoid , P posterior deltoid (Modified with…
