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Musculoskeletal infection

Nicholas Said, Majid Chalian, Michael G Fox, Nicholas C Nacey
OBJECTIVE: Image-guided percutaneous bone biopsy may be requested by clinicians to guide antibiotics management decisions in patients with extremity osteomyelitis. Much of the clinical literature describes a high rate of bone biopsy culture positivity in patients with osteomyelitis, but anecdotally biopsy is felt to be fairly low yield in many musculoskeletal radiology practices. The objective of the study is to determine the culture positivity rate and clinical utility of bone biopsy in guiding the management of patients with osteomyelitis...
February 19, 2019: Skeletal Radiology
Fernando Brandão Andrade-Silva, Renan Lyuji Takemura, Renato Tavares Bellato, Marcos de Camargo Leonhardt, Kodi Edson Kojima, Jorge Dos Santos Silva
Objectives: To describe the clinical utility of the Manchester triage scale adapted for orthopedic emergency departments and to evaluate its validity in identifying patients with the need for hospital care and its reliability when reproduced by different professionals. Methods: Five triage flowcharts were developed based on the Manchester scale for the following orthopedic disorders: traumatic injuries, joint pain, vertebral pain, postoperative disorders, and musculoskeletal infections...
January 2019: Acta Ortopedica Brasileira
Pradeep S Salve, Praveen Chokhandre, Dhananjay W Bansod
Study assesses the effects of solid-waste loading on workers, the resultant development of occupational morbidities, and economic burden of these morbidities. A cross-sectional survey was conducted with 360 municipal workers from six of 24 municipal wards in Mumbai. The nearest neighborhood method of Propensity Score Matching (PSM) examined the impact of waste-loading on the development of morbidities and to identify the risk factors - multiple logistic regression analysis was performed. The prevalence of musculoskeletal disorders (MSDs), injury, eye and skin infections found significantly higher for waste-loaders compared to comparison group...
February 17, 2019: Archives of Environmental & Occupational Health
José M Pego-Reigosa, Juliana Restrepo Vélez, Chiara Baldini, Íñigo Rúa-Figueroa Fernández de Larrinoa
The information about comorbidities (excluding lymphoma) in primary Sjögren's syndrome (pSS) is relatively scarce. Cardiovascular disease, infections, musculoskeletal conditions or malignancy are likely the most relevant comorbid conditions in pSS. Different infections (particularly oral candidal infections) and fibromyalgia are extremely frequent in the daily clinical practice. On the other hand, the incidence of cardiovascular events and cancer in pSS is low, so information about them comes from large epidemiological studies or meta-analysis...
February 15, 2019: Rheumatology
S Ranque-Garnier, C Eldin, C Sault, D Raoult, A Donnet
Lyme disease is caused by bacteria of the B. burgdorferi sensu lato complex, and can give polymorphic clinical manifestations that can affect several organs such as the skin, the central nervous system, or the joints. In recent years, patients' associations and physicians have been supporting the hypothesis that this infection would manifest as chronic generalized musculoskeletal pain symptoms, named "chronic Lyme disease". Fibromyalgia is a clinical presentation characterized by chronic generalized musculoskeletal pain with a major impact on quality of life and social and psychological functioning...
February 11, 2019: Médecine et Maladies Infectieuses
Markus R Konieczny, Rüdiger Krauspe
STUDY DESIGN: This study was a retrospective radiographic analysis of consecutive patients. OBJECTIVES: To analyze exposure to radiation of the surgeon and-separately-of patients in minimally invasive surgery (MIS) of multilevel posterior stabilization by percutaneous pedicle screw insertion guided by navigation (PIN) versus percutaneous pedicle screw insertion guided by fluoroscopy (PIF). SUMMARY OF BACKGROUND DATA: Spine surgeons are exposed to a 12-fold higher dose of radiation than other nonspinal musculoskeletal surgeons and PIF in MIS leads to a 2-fold higher dose of radiation than in open surgery...
February 12, 2019: Clinical Spine Surgery
Kheng Song Leow, Kian Ming Chew, Ashish Chawla, Tze Chwan Lim
Calf pain or swelling is a common presentation to the emergency department. The differential diagnoses are wide. Deep vein thrombosis (DVT) is often the first diagnosis to be excluded given its potentially fatal complications. Musculoskeletal causes of calf pain or swelling such as Baker's cyst, muscle or tendon tear, soft tissue infection, and inflammation are not uncommon and can often be confidently diagnosed with ultrasonography (US). Familiarity with these conditions and the sonographic findings would be useful in making timely and correct diagnosis...
February 13, 2019: Emergency Radiology
Hannah L Khiangte, Leena Robinson Vimala, Balaji Veeraraghavan, Binesh Lal Yesudhason, Reka Karuppusami
OBJECTIVE: Melioidosis being an important cause of community-acquired sepsis, caused by Burkholderia pseudomallei in the tropical and subtropical countries, is often underreported or misinterpreted on imaging investigations. We aim to describe the spectrum of imaging manifestations of melioidosis and to evaluate its role in prognosticating clinical outcome, and look for association of specific organ involvement with risk factors. METHODS: From January 2011 to October 2017, retrospective analysis of imaging investigations of 189 consecutive patients with culture-proven melioidosis was performed...
February 13, 2019: Insights Into Imaging
Vajra Badha, Rex Moore, John Heffernan, Paulo Castaneda, Alex McLaren, Derek Overstreet
Background : Bacterial biofilms cause chronic orthopaedic infections. Surgical debridement to remove biofilm can be ineffective without adjuvant local antimicrobials because undetected biofilm fragments may remain in the wound and reestablish the infection if untreated. However, the concentrations and duration of antimicrobial exposure necessary to eradicate bacteria from clinical biofilms remain largely undefined. In this study, we determined the minimum biofilm eradication concentration (MBEC) of tobramycin and vancomycin for bacterial biofilms grown on bone and muscle in vitro ...
2019: Journal of Bone and Joint Infection
Lenka Krbková, Kateřina Kybicová, Dušan Pícha, Hana Roháčová, Dita Smíšková
The national guideline aims to highlight the latest knowledge about clinical manifestations of the infection, to summarize the diagnostic algorithm and to recommend the appropriate antibiotic therapy with respect to evidence-based medicine. The recommendations are consistent with most European guidelines as well as those published by the IDSA. The guideline provides the most recent information on the epidemiology, etiology and pathogenesis of Lyme borreliosis, dermatological, neurological and musculoskeletal involvement, the appropriate diagnostic procedure and prevention...
September 2018: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
Benjamin Tk Ding, Kelvin Guoping Tan, Chung Yuan Kau, Henry Ying Ho Chan, Muhd Farhan Bin Mohd Fadil
OBJECTIVE: This study aimed to test the accuracy of the Synovasure®, α-defensin lateral flow test kit, in diagnosing periprosthetic joint infections (PJIs) in a predominantly Asian population and to evaluate whether other patient or disease factors may affect its results. METHODS: 61 Asian patients comprising 70 hip or knee prosthetic joints, performed between November 2015 and November 2018, were retrospectively evaluated. Cases were categorized as infected or not infected using Musculoskeletal Infection Society (MSIS) Criteria...
January 2019: Journal of Orthopaedic Surgery
Abdulrahman D Algarni
Prepatellar bursal infection is a rare occurrence. The incidence of tuberculosis, including musculoskeletal type, is increasing. We present a case of isolated prepatellar bursal swelling associated with a discharging sinus; the condition developed in an elderly patient 4 years after total knee arthroplasty. Aspiration of the bursa revealed acid-fast bacilli on Ziehl-Neelsen staining, typical of Mycobacterium tuberculosis ; this was confirmed later on culture. The patient was successfully treated with a 6-month course of antituberculous chemotherapy...
2019: Case Reports in Infectious Diseases
Raffaele Vitiello, Marco Lillo, Fabrizio Donati, Giulia Masci, Giovanni Noia, Vincenzo De Santis, Giulio Maccauro
BACKGROUND AND AIM: Femoral shaft fracture is a common traumatic musculoskeletal injures in pediatric population. The treatment of diaphyseal femoral fractures depends on age patient and pattern fracture. We present our record about the use of locking plate fixation and their outcomes. METHOD: We conduct a retrospective analysis in 22 patients, surgically treated for 26 diaphyseal femur fracture between 2008 and 2013. The mean age was 13 years. All the patients underwent a clinical and radiological follow-up for two years...
January 14, 2019: Acta Bio-medica: Atenei Parmensis
Marcel-Philipp Henrichs, Dennis Liem, Georg Gosheger, Arne Streitbuerger, Markus Nottrott, Dimosthenis Andreou, Jendrik Hardes
BACKGROUND: The distal humerus is a rare location of bone tumors. Because of the complexity of the elbow joint, poor soft-tissue coverage, and proximity of nerves and vessels, resection and endoprosthetic reconstruction are demanding. METHODS: This retrospective study evaluated the clinical results after distal humeral resection and megaprosthetic reconstruction in 12 patients with an average age of 46 years. All patient files were reviewed for clinical information, and postoperative function and patients' contentment were assessed using the Musculoskeletal Tumor Society score...
February 1, 2019: Journal of Shoulder and Elbow Surgery
Anna Hellkvist, Johan Wikström, Ajlana Mulic-Lutvica, Katharina Ericson, Christopher Eriksson-Falkerby, Peter Lindgren, Eva Penno, Ove Axelsson
INTRODUCTION: Our aim was to investigate the accuracy of postmortem fetal magnetic resonance imaging (MRI) compared to fetal autopsy in second trimester pregnancies terminated due to fetal anomalies. A secondary aim was to compare the MRI evaluations of two senior radiologists. MATERIAL AND METHODS: This was a prospective study including 34 fetuses from pregnancies terminated in the second trimester due to fetal anomalies. All women accepted a postmortem MRI and an autopsy of the fetus...
January 29, 2019: Acta Obstetricia et Gynecologica Scandinavica
Bryant J Webber, Alan M Flower, Sonal R Pathak, Rachael P Burganowski, Mary T Pawlak, Ryan C Gottfredson, Brian K White, James A Young
Introduction: Many epidemiologic studies have been performed in military recruit populations, but little is known about the health of those who conduct the training. This study aims to characterize the physical and mental health of a military trainer cohort. Materials and Methods: All US Air Force military training instructors (MTIs) who served between 1 October 2011 and 30 September 2016 were included in this retrospective descriptive study. All International Classification of Diseases, Ninth or Tenth Revision codes received by MTIs as inpatients or outpatients in the TRICARE system were obtained and mapped to Clinical Classifications Software levels...
January 23, 2019: Military Medicine
Kazuhiko Kido, Austin A Oyen, Morgan A Beckmann, Sara D Brouse
Purpose: This article evaluates the musculoskeletal safety of concomitant therapy with daptomycin and Hydroxymethylglutaryl-coenzyme A (HMG CoA) reductase inhibitors (statins). Summary: Often indicated for severe gram-positive infections, daptomycin is commonly administered with statins but there is limited guidance on the appropriate management of concomitant therapy with daptomycin and statins. A narrative review was conducted to review contemporary clinical evidence of the safety of concomitant therapy with daptomycin and statins...
January 21, 2019: American Journal of Health-system Pharmacy: AJHP
James P Moley, Mary S McGrath, Jeffrey F Granger, Anne C Sullivan, Paul Stoodley, Devendra H Dusane
While the detrimental effects of periprosthetic joint infections (PJIs) are well known, the process of biofilm formation on orthopaedic hardware is unclear. Previous work has shown that encasement of explant hardware in agar can aid in identifying biofilms. This study tested the utility of agar 'candle dip' method in detecting and mapping the location of biofilm on infected orthopedic components. Explant components from 15 patients were rinsed, briefly submerged in agar to create a surface coating, and incubated...
January 27, 2019: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
T Graulich, D Steimer, D Zhang, M Omar, S Weber-Spickschen, C Krettek, M Panzica
INTRODUCTION: Total femoral replacement (TFR) is a limb salvage procedure performed for large bony defects. However, it is often associated with major complications and reduced function. Data on limb preservation rates and functional outcomes after TFR are limited. The primary objective of this study is to assess indications, functional outcomes, and complications after TFR. MATERIALS AND METHODS: We retrospectively analyzed all patients after TFR between 2006 and 2016...
January 28, 2019: Archives of Orthopaedic and Trauma Surgery
Françoise Derouane, Michel Lambert, Julien De Greef, Jacques Malghem, Frédéric E Lecouvet
Infection of costal cartilage is a rare observation. We report the case of a 43-year-old male patient without relevant history who presented with a progressive painful swelling of the left chest wall since 4 months. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated an abscess within the left ninth costal cartilage with surrounding reactive changes. A CT-guided biopsy was performed and the culture of the sample revealed the presence of Prevotella nigrescens. Musculoskeletal infections by Prevotella are rarely described in the literature, Prevotella oralis and Prevotella bivia being the most frequently observed pathogens...
January 26, 2019: Skeletal Radiology
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