No abstract available.
Osteomyelitis

No abstract available.
Osteomyelitis*

No abstract available.
Osteomyelitis*

Osteomyelitis in children has various clinical manifestations causing diagnostic and therapeutic difficulties. Inappropriate treatment of acute osteomyelitis may lead to chronic, serious and complicated condition. Chronic osteomyelitis continues to be a major cause of morbidity and disability in children living in developing countries. We present three cases of tibial osteomyelitis that have different presentations and sequalae. Our intention is to alert our colleagues, particularly primary physicians, regarding the variety of presentation and the important of early diagnosis and treatment to reduce the risk of morbidity following osteomyelitis.
Osteomyelitis

No abstract available.
Osteomyelitis*

OBJECTIVE: This study aimed to evaluate the inter- and intraobserver reliability of the Penny and Beit CURE radiologic classifications of pediatric patients with Chronic Hematogenous Osteomyelitis (CHOM) in the Philippine General Hospital (PGH). METHODS: Thirty-four pre-operative radiographs of PGH pediatric patients with CHOM were classified by seven orthopedic surgeons using both Penny and Beit CURE Classification systems. Two sets of radiographs were sent to the surgeons twice, four weeks apart, to classify. The Fleiss and Cohen κ statistics were used to determine inter- and intraobserver reliabilities, respectively. RESULTS: The Penny Classification had a slight to fair interobserver reliability (Fleiss κ = 0.17 and 0.24) and a fair intraobserver reliability (Cohen κ =0.35) with a 49.58% average intraobserver agreement. The interobserver reliability when including all Beit CURE classification subtypes was fair (κ = 0.28 and 0.31). This improved to moderate (κ = 0.41 and 0.54) when using only the four main types of the Beit CURE classification with a 77.31% intraobserver agreement. CONCLUSION: The Beit CURE classification for pediatric CHOM had higher inter- and intraobserver agreement rates than the Penny classification. Further improvement in reliability can be made by combining B2 and B3 subtypes under the Beit CURE classification.
Osteomyelitis

Introduction: Imaging modality has become increasingly important in hospital setting especially in cases of unknown site of infection/pyrexia of unknown origin (PUO) and osteomyelitis (OM). In recent years, nuclear imaging has been used and is known to deliver prompt and precise diagnoses of numerous infectious diseases. The purpose of the study is to detect and localise the site of infection using Tc99m-besilesomab and to assess the added contributions of single photon emission computed tomography/computed tomography (SPECT/CT) over planar scan in patients with PUO and OM. Methods: Tc99m-besilesomab with SPECT/CT were prospectively performed in 23 patients (eight males, 15 females) with suspected infection. True findings were diagnosed by both cold and hot spot in the scan with reference to positive blood or tissue cultures, or other additional imaging. Results: Tc99m-besilesomab managed to detect presence of infection with high sensitivity of 87.5% and specificity of 71.4%. Interobserver variability agreement that was obtained between the presence of infection and the ability of Tc99m-besilesomab imaging to detect it was significant (p<0.05), Kappa=0.7. SPECT/CT has increased the detection sensitivity by 6.3% and specificity by 28.6%. Out of 23 patients, 15 had true positive, seven had true negative and only one patient had false negative study. SPECT/CT has changed the management in one patient which was missed by planar imaging. Conclusions: Indeed, SPECT/CT has further increased the detection sensitivity and specificity, provides extra information of the anatomical location and the extent of involvement of the disease as compared to planar imaging alone.
Osteomyelitis

No abstract available.
Diagnosis* ; Osteomyelitis*

No abstract available.
Femur* ; Osteomyelitis*

Aims: Accurate diagnosis and proper treatments of osteomyelitis are often difficult and ineffective due to several reasons such as less sensitive sample collected and the formation of biofilm following prosthetic use. Thus, our goal of this study is to identify suitable sample for laboratory diagnosis and also microbial species that cause osteomyelitic infection and discriminate between biofilm and non-biofilm producing strains in patients at Hospital Tengku Ampuan Afzan, Kuantan. Methodology and results: Samples of bone, prosthetic material, tissue and swab were collected from patient with suspected osteomyelitis at the hospital. Bacteria were isolated from sample using methods such as homogenization, direct transfer, and sonication. Then, species identification was done by colony characterization, biochemical test and the API identification system. Once species identified, tissue culture plate method was performed to discriminate the biofilm-producing strain from the non-biofilm-producing strain. The total number of 57 samples were collected from 17 cases of suspected osteomyelitis with 34 samples were found positive bacterial growth. Prosthetic samples produced highest positive growth with 81.3%, following by bone samples with 66.7% while swab and tissue samples with 46.2% and 43.8% respectively. We found that 14 from total 16 pathogens identified were biofilm producing-strains. Conclusion, significance, and impact of study: Prosthetic and bone samples produced higher bacterial growth, in contrast to other type of samples. Sonication method improves bacterial detection. Biofilm producing-bacteria were also the most common isolated strains from osteomyelitic infection. These have underscored the need to revise current clinical and laboratory practice as proper identification biofilm bacteria may influences management an outcome.
Biofilms ; Osteomyelitis