Ogden J A
Yale J Biol Med. 1979 Sep-Oct;52(5):423-48.
The morphologic and histologic examination of over fifty-five foci of metaphyseal/epiphyseal osteomyelitis and eleven septic joints from five cases of neonatal osteomyelitis and joint sepsis are described in detail. The severity of the bone and joint involvement varied considerably, allowing a better understanding of the pathophysiologic sequence of events in the disease in the neonatal time period. Of particular importance were (1) the multifocal nature of the disease, (2) the highly variable destruction of the growth plate (physis) by several discrete mechanisms, and (3) the invasion of the chondroepiphysis through the cartilage canal systems. Two of the cases died from respiratory complications several months following presumed successful treatment of their skeletal infections. S&pecimens showed significant growth plate damage continuing beyond the neonatal period. These findings support the need for rapid diagnosis and drainage, whenever feasible, to prevent long-term skeletal growth damage. The severity of involvement also should emphasize that this disease, especially in the neonate, is not an innocuous condition, as a recent review suggested.
详细描述了对5例新生儿骨髓炎和关节脓毒症中55个以上干骺端/骨骺骨髓炎病灶及11个化脓性关节进行的形态学和组织学检查。骨和关节受累的严重程度差异很大，这有助于更好地理解新生儿期该疾病的病理生理事件顺序。特别重要的是：（1）疾病的多灶性；（2）生长板（骺板）通过几种不同机制受到高度可变的破坏；（3）软骨骨骺通过软骨管系统受到侵犯。其中2例在骨骼感染假定成功治疗数月后死于呼吸并发症。标本显示生长板损伤在新生儿期后仍持续存在且较为严重。这些发现支持在可行的情况下进行快速诊断和引流，以防止长期骨骼生长受损。受累的严重程度还应强调，正如最近一篇综述所指出的，这种疾病，尤其是在新生儿中，并非无害病症。
