bone inflammation

The term bone inflammation (osteitis) is increasingly used as a synonym of bone marrow inflammation (osteomyelitis), since not only the bone marrow, but all components of the bone may be affected.

Contents:
causes
symptoms
diagnosis
therapy

causes

In most cases, bacterial contamination due to open fractures or surgery is the cause. One speaks also of the postpoerativen bone inflammation. Bacteria invade the bone and find favorable conditions there due to the nature of the bone tissue. If the trauma is supplied with osteosynthesis, ie with foreign material such as plates and screws, an environment is created in which the immune system of the affected person can not be fully effective. This favors the inflammatory process.

The infiltration of an adjacent infection in the bones, such as from the antrum through the bloodstream, is referred to in medicine as endogenous (from the outside) or hematogenous (via the bloodstream) bone inflammation and occurs more in childhood, since the growth joints of the Childlike bones are not yet closed and so the pathogens find a favorable for their blood circulation situation. In addition to bacteria (in three quarters of cases it is the pathogen to Staphylococcus aureus) both viruses, and fungi can cause bone inflammation.

Bone inflammation symptoms

If there is postoperative infection of the bone and its components, it is called acute bone inflammation. It often shows local signs of inflammation such as redness, swelling, a rise in temperature and pain in the operating area. Possible is an increased body temperature of the patient as well as a visible increase in the inflammatory parameters in the laboratory.

In the further course, the pathophysiological reaction of the body is a foreclosure of the infected area in order to prevent further spread. Around the necrotized bone tissue is formed a protective capsule enclosing the pathogen. Thus, in an otherwise unremarkable region, pus can drain through a fistula tract, which is extremely painful in the affected body region. The increase in inflammatory parameters in the laboratory is no longer as clear as in acute bone inflammation, but now radiographic changes are visible.

Furthermore, patients feel tired and tired. After only a few days, it can lead to joint and limb pain. Frequently affected joints are located in the upper arm area near the shoulders as well as in the region around the knee joint. As the inflammation progresses, the stability of the bone can be severely compromised and bone fractures can follow.

diagnosis

The diagnosis of bone inflammation is performed by X-ray, CT, MRI, sonography (ultrasound), scintigraphy (imaging technique with contrast agent) and by questioning the patient.

therapy

The treatment of bone inflammation is often a long-lasting process, since first the pathogen must be recognized as the cause and treated before an osteosynthetic supply of the bone is possible. It is important that the bone gains stability quickly and no "false joints", so-called pseudarthrosis, form. In the case of chronic bone inflammation, it is first necessary to completely eliminate fistulas and poorly perfused tissue before absorbable antibiotics can be used.

Should a great deal of bone tissue be affected, a bone graft is indicated. In this case, plate bone, usually the iliac crest, is used to punch tissue and implant it in the affected area. Often this procedure is required several times. Today, a combination of both methods is used in therapy by impregnating bone grafts with antibiotics before transplanting. This reduces the risk of further surgeries and the active ingredients reach the site of the infection directly. (Philipp Schulz, physiotherapist)