Infections of bone, joints and muscle

27. Infections of bone, joints and muscle


Infections of bone may arise from haematogenous and exogenous sources (Fig. 3.27.1). Bacteraemias in adults, particularly with Staphylococcus aureus and Brucella sp., may seed into adjacent vertebrae with their intervertebral disc (discitis). In prepubertal children, the metaphysis of tibia and femur may develop small post-traumatic haematomas under the growth plate, into which occult bacteraemia may nidulate. Patients with sickle cell disease are particularly at risk of salmonella osteomyelitis. In countries where tuberculosis is endemic, mycobacteria can settle in those niduses. Exogenous entry of bacteria occurs through open fractures, deep soft tissue defects (diabetic foot ulcers, decubital ulcers) or during surgical insertion of metal plates or prostheses. Prosthetic infections occur in less than 1% of elective total joint replacements; however, they are more common after hemiarthroplasties for traumatic fractures of the neck of femur.

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Jul 3, 2016 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Infections of bone, joints and muscle

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