Eid Albert J, Berbari Elie F
Division of Infectious Diseases, University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
J Med Liban. 2012 Jan-Mar;60(1):51-60.
Osteomyelitis can affect every bone and is heterogeneous in its pathophysiology and presentation. When the diagnosis is clinically suspected, further studies such as serum inflammatory markers and imaging studies should be performed. Magnetic resonance imaging can be very useful in establishing the diagnosis and determining the extent of infection. When possible, bone specimens should be obtained and cultured prior to the initiation of antimicrobial therapy. Surgical debridement is often required for chronic or contiguous osteomyelitis for successful eradication of the infection. The ultimate test-of-cure is the lack of clinical relapse after the discontinuation of antimicrobials.
骨髓炎可累及每一块骨头,其病理生理学和临床表现具有异质性。当临床上怀疑有诊断时,应进行进一步检查,如血清炎症标志物检查和影像学检查。磁共振成像在确立诊断和确定感染范围方面可能非常有用。如有可能,应在开始抗菌治疗前获取骨标本并进行培养。对于慢性或邻近性骨髓炎,通常需要进行手术清创以成功根除感染。治愈的最终检验标准是停用抗菌药物后无临床复发。