osteomielitis ppt
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RESPONSIOSTEOMYELITIS
Pebimbing:dr. Erwien Isparnadi, Sp.OT
SMF BEDAH RSU HAJI SURABAYA FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH MALANG
2015
Disusun oleh:Maulana Saputra (201410401011007)
PENDAHULUAN
Osteomyelitis is an inflammation of the bone caused by a bacterial infection.
The incidence of Osteomyelitis range between 0,1 to 1,8% of the adult population.
The mortality of osteomyelitis ± 5-25%.
DEFINITION
• Osteomyelitis is an acute or chronic inflammatory process of the bone and its structures due to infection by pyogenic bacteria.
Epidemiologi
• 50% osteomyelitis occurs in children less than 5 years.
• 10-30% acute osteomyelitis progressed to chronic osteomyelitis.
ETIOLOGI
Staphylococcus aureus
(89-90%)
Escherichia coliPseudomonas
Klebsiella
PATOFISIOLOGI
osteomielitis
Hematogen
lokal
KLASIFIKASI
Cierney dan Mader
GAMBARAN KLINIS
General• Fever • Malaise• Nausea• AnoreksiaLocali• Painful• Edema• Hiperemi
Diagnosis
• Anamnesis• Physical diagnostic• Radiologi• Kultur
RADIOGRAFI
Reaksi periosteal osteolisis distal metatarsal IV dan distal phalanges III IV
RADIOGRAFI
Deformitas femur Sklerosis sumsum
RADIOGRAFI
MRI femurInhomegenitas
DIFERENSIAL DIAGNOSIS
• Arthritis Supuratif Acute• Osteosarcoma
Therapi
• Antibiotic• Antipiretik• Fluid• Debridement
15
16
COMPLICATION
17
Septikemia Artritis Supuratif
Osteomyelitis Kronik
Fraktur Patologis
PROGNOSIS
18
• Mortalitas osteomyelitis ± 5-25%.
• 10-30% acute osteomyelitis progressed
to chronic osteomyelitis.
CASE REPORT• Name : Tn. Sumarno• Ages : 50 tahun• Gender : Laki-laki• Address : Tambak Pondok
Legi II/B Surabaya• Religions : Moeslem• Ethnic : Jawa• Educational : Elementary
School• Occupation : Driver • No. register : 698751
ANAMNESISPain in the thigh knee
Patient came with Pain in the left thigh since one
year ago, the pain worse at late 4 month. Firstly
there was knee swelling and redness appearing on
his left thight and the patient felt pain. The pain was
intermittent in late 4 months. The pain increased
when the patient walking. Patient used tawon oil but
there was no effect. Sometimes patient felt his body
temperature elavated. one year ago, patient has
done fracture surgery on his left thigh.
Past Medical History
• DM (-)• HT(-)• Alergic (-)• Asma (-)
Phisical Examination
General condition : Fine Vital Sign• BP : 120/70 mmHg• N : 78 x/minutes• RR : 17 x/minutes• t : 36,30 C
• K/L : A/I/C/D -/-/-/- , palpebral oedem (–), rinorhea (-), otorhea (-), periorbital hematome (-).
• Thorax : Pulmo: I : normochest, (-)P : symmetric expantion
P : sonor/sonorA : VBS +/+ , ronchi -/-, wheezing -/-
Cor: I : IC (-)P : thrill (-)P : cardiac border: normalA : S1S2 single, murmur (-), gallop (-)
• Abdomen :I : Flat, symmetricP : Soepel, tenderness (-)P : Tympani, meteorismus (-)A : bowel (+) normal
• Ekstremitas: AKHM +/+
+/+
Oedem -/- -/+
REGIO FEMUR SINISTRA:
• Look: hyperemi (+), edema (+)ulcus (-), fistule (-), pus (-)
• Feel: calor (+), crepitate (-), pain (+)
• Move: ROM limited
X-Ray :sklerotic distal os femur.Osteophyte at medial condylus et lateral tibia and supero-infero posterior margo os patella.Fracture (-)Osteolitik/blastik (-)Soft tissue swelling (-)
Chronic osteomyelitis et femur distal S
– Diagnosis Planning : DL
– Diagnosis: Chronic Osteomyelitis 1/3 Femur Distal sinistra
– Therapy:
1. Wound Toilet2. MedikamentosaCefixime 2 x 100 mg and
Paracetamol 3 x 500 mg
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