Specialists

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Vertebral Osteomyelitis

Basics

Description Infection of the vertebral bony elements, not including the disc space General Prevention Prevention of HIV and hepatitis Early treatment of hematogenous infection Postoperative wound care, including dressing changes and prophylactic postsurgical antibiotics Epidemiology Bimodal distribution: Small peak in youth (10-20 years old) Largest peak in adults >50 years old Increasing rates in […]

Skeletal Scintigraphy

Basics Description Skeletal scintigraphy is a nuclear medicine imaging method for bone disease. Advantages: High sensitivity for early detection of disease Whole body survey Disadvantage: Limited specificity Diagnosis Signs and Symptoms Indications Whole body skeletal scintigraphy: Primary bone tumors Osteomyelitis Joint prosthesis pain Occult fractures Stress fractures and shin splints Spondylosis Reflex sympathetic dystrophy […]

Septic Hip

Basics Description The incidence of septic hip is increasing, especially in elderly and immunosuppressed individuals. This condition may occur in infants, children, adults, and the elderly, but it is more common in the pediatric population. Risks factors include hip surgery (most common cause), intravenous drug abuse, alcoholism, and steroid use. Epidemiology Incidence In children, […]

Septic Arthritis

Basics Description Septic arthritis is an infection of the joint. In infants, the capillaries penetrating the physeal plate into the epiphysis persist until age 18 months, so spread of infection may occur from the metaphysis indirectly to the epiphysis and then to the joint. Possible irreparable damage to growth plate occurs. Classification: Polyarticular septic […]

Puncture Wounds of the Foot

Basics Description Puncture injuries of the foot typically occur on the plantar surface of the forefoot or heel. The injuring object usually is a nail, needle, or pin, but it can be anything that punctures the soft tissue, including thorns, glass, and splinters. Classification: Early presentation: Day of injury Late presentation: At least 3-5 […]

Osteomyelitis

Basics Description Osteomyelitis is inflammation or infection of bone. Classification is most commonly based on the timing of onset: Acute: Most often from hematogenous spread: The most common organism in neonates is Staphylococcus aureus, followed by Streptococcus or Gram-negative organisms. In older infants and children, it usually is S. aureus. Subacute: Accounts for 1/3 […]

Open Fractures

Basics Description Open fractures are defined as situations in which the fracture site communicates with the outside environment. The bone does not need to protrude from the skin for the injury to be an open fracture. Any full-thickness skin laceration in the zone of fracture injury is considered an open fracture. Open fractures can […]

Nonunion of Fractures

Basics Description Presence of a postfracture defect in a long bone beyond a reasonable expected healing date, or if no radiographic progression of healing is noted If internal fixation is used to stabilize a fracture, a race exists between fracture healing and hardware failure. Children, because of their active healing potential, rarely develop a […]

Neck Pain

Basics Description In adults: Common Usually secondary to degenerative disc disease and arthritis In children and adolescents: Less common When it does occur, the pain often is secondary to a neoplasm or infection. Neck pain also occurs after trauma and is extremely common after motor vehicle accidents. General Prevention No definite methods of prevention […]

Musculoskeletal Radiography

Basics Description Plain radiography has been the primary musculoskeletal imaging technique for >100 years. X-ray beams generated by an x-ray tube pass through the body part to be imaged, and differential absorption and scattering of the x-ray beams occur. The exiting beam carries information about the density of the material traversed. This information is […]