Inflammation of bone tissue - osteitis. Treatment of bone osteomyelitis

Osteitis (from the Greek osteon, meaning “bone”) is a disease characterized by inflammatory processes in bone tissue.

Such inflammation can develop in it as a result of exposure to traumatic factors or infection, and is mainly associated with fractures or unsuccessful surgical intervention on the bones. This inflammation is nonspecific. Specific bone inflammation occurs due to the spread hematogenously tuberculosis, syphilitic and other infections. In many cases, osteitis refers to bone lesions that occur with tuberculosis, in particular with tuberculous arthritis.

The course of osteitis is chronic or can take an acute form. IN acute condition the bone is subject to destruction, and in a chronic disease, a predominance of proliferation processes is noted. When congenital and tertiary syphilis occurs, they speak of syphilitic, ossifying and resolving osteitis.

Each of the above types of bone tissue damage involves treatment using certain appropriate measures. So, in the presence of specific osteitis, the focus of medical measures is directed primarily to the underlying disease. In other cases, it may be more appropriate to prescribe surgical treatment to sanitize the focus of the inflammatory process. Surgery is accompanied by the use of antibacterial, desensitizing, and immunostimulating drugs.

When osteitis is diagnosed in a timely manner and the necessary treatment is started as soon as possible rational treatment, the prognosis for its course is favorable with a high probability of complete recovery.

ICD-10 code

M89 Other bone diseases

Causes of osteitis

The causes of osteitis are represented by two main groups of factors causing the occurrence of this disease.

The most common of them is a traumatic violation of the integrity of the bone due to a blow, bruise, fracture (open or closed), as well as due to surgical intervention for the latter. Fractures carry the danger that, due to them, purulent microflora may appear in the wound.

With regard to microflora, it should be noted that specific types of microflora, such as syphilitic and tuberculosis, can also provoke osteitis. For their cause, syphilitic and tuberculous osteitis occurs, respectively. The explanation for this is that when a person has syphilis or tuberculosis, infection through the circulatory system can spread throughout the body, including bone tissue.

Medical statistics also note a limited number of cases in which osteitis occurred against the background of diseases such as brucellosis, gonorrhea, leprosy, paratyphoid fever and rheumatoid arthritis.

Thus, the causes of osteitis mainly come down to mechanical impact traumatic nature on the bone, and besides this to various factors infectious pathogenesis. Based on this, depending on what caused the bone inflammation characteristic of osteitis, the appropriate method of treatment is selected.

Symptoms of osteitis

Symptoms of osteitis and the degree of their severity are determined by the etiology, extent of prevalence pathological process, what is the objective general condition of the patient, and it is also noted whether any concomitant diseases and dysfunctions of the body have appeared in connection with osteitis.

Progression of osteitis can often occur without revealing its presence by any signs. noticeable manifestations until at some point an exacerbation occurs.

As a rule, acute osteitis is accompanied by the appearance of local pain symptoms. Subsequently, some swelling occurs, and the functioning of the affected area of ​​the limb or spinal column changes negatively. The possibility is not excluded pathological fractures, formation of secondary deformations. There are dysfunctions of the nerves and spinal cord, which is typical for spondylitis, that is, tuberculosis of the spine. If the periosteum and soft tissues are affected by inflammatory processes, the occurrence of fistulas and phlegmons is observed.

Chronic osteitis may essentially represent a further development of chronic periodontitis. In this case, the disease manifests itself in the form of thickening of the jaw bone, which is unilateral or bilateral in nature. In this case, significant areas of the jaw may be involved in this process. Up to the point that inflammation will cover its entire half on the right or left, depending on the location of the osteitis.

The occurrence of exacerbations is noted under certain circumstances as a result of unfavorable conditions. These include colds stressful conditions etc. Clinical picture in this case, it is similar to an acute process. As for the time factor, it seems possible to identify it only on the basis of anamnesis and radiographs.

Symptoms of osteitis can be completely subtle, and the presence of the disease is often determined only at the stage of its exacerbation. Based on this, diagnosing in the early stages of development of such bone inflammation, since without appropriate treatment, osteitis may have a tendency to significantly spread the lesion in human body.

BCG osteitis

The BCG vaccine was first used in 1923. Subcutaneous administration of the drug has been practiced since 1962 and since then to this day remains the only means of vaccination against tuberculosis. BCG is the Russian transcription of BCG, an abbreviation for Bacillum Calmette Guerin, as the culture is called after its creators, who were the French scientists A. Calmette and C. Guerin.

Vaccination using BCG helps prevent the development of tuberculosis in its most severe forms, which are tuberculous meningitis and fulminant tuberculosis. Up to one hundred million children receive this vaccine every year.

However, with the use of this vaccine, it is still impossible to be absolutely sure that it will not cause the occurrence of all kinds of post-vaccination complications. And although they are reflected in extremely small numbers (0.004-2.5%), nevertheless, they take place.

Along with the most common negative consequences, manifested in damage to the regional supra- and subclavian, axillary, and cervical lymph nodes, it is now also noted that osteitis often develops after BCG vaccination.

It is generally accepted that the main reasons for this lie in the possible dishonesty of the person performing the manipulation, in violation of the technique for its execution. This may be too deep a vaccine into the skin or a dose that exceeds the prescribed norm. The consequences of such actions can cause a variety of negative local reactions in the form of necrotic phenomena in tissues, the occurrence of ulcers, lymphadenitis, keloid and cold abscess, as well as lupus in the place where the vaccine was administered.

Vaccination without taking into account can also lead to the appearance of BCG osteitis. existing contraindications, then when this vaccination is unacceptable due to the individual characteristics of the response from immune system child.

BCG osteitis, as well as many other possible negative reactions of the child’s body to vaccination, can only be excluded if the vaccination is entrusted to a qualified specialist.

Tuberculous osteitis

Tuberculous osteitis is characterized by a specific type of inflammation, which mainly occurs in those parts of the human skeleton in which red, hematopoietic, and myeloid bone marrow is present in large quantities.

The greatest extent of damage occurs in the vertebral bodies, in the metaphyses of the tibia, femur and humerus. The bodies of the pubic, iliac, and ischial bones are also susceptible to the development of this disease.

The localization of inflammation is predominantly single, but sometimes this kind of lesion can sometimes occur in several parts of the skeleton.

Regarding the age of a person at which there is high probability the appearance of this disease, then the risk group includes the period of childhood and adolescence.

Foci of inflammation with the greatest frequency are observed in close proximity to the joints, which, under certain circumstances, can become a factor causing the possibility of spreading to a nearby joint. In the absence of appropriate treatment, this can be aggravated by the appearance of inflammation in the synovium of the joint capsule. On the other hand, if the focus of inflammation in tuberculous osteitis is located at a distance from the joint, then its encapsulation is possible, but this can only happen if the human body has good resistance.

Tuberculous osteitis is characterized by a long time of development and course of the pathological process and in the early stages is not accompanied by any significant pain symptoms, due to which it often does not cause any anxiety in the patient. But here lies main danger of this disease. After all, this is why many delay the start of treatment for a long time, which ultimately leads to a very unfavorable result.

Osteitis of the jaw

Osteitis of the jaw is a disease in which inflammatory processes occur in the bone tissue. A frequent accompanying phenomenon is also inflammation of the periosteum, which is called periostitis. In addition, phlegmon and fistulas can form, as well as inflammation of the bone marrow - osteomyelitis.

The occurrence of osteitis of the jaw may be indicated by the appearance of pain in any part of the jaw. Further, some swelling is observed in that place, which causes difficulties in the process of chewing food. And subsequently painful sensations are already noted throughout the jaw.

Strong mechanical damage due to blows, injuries, bruises that resulted in a fracture of the jaw bone. The consequences of unsuccessful surgical intervention are also the cause.

Osteitis can appear in the jaw due to the fact that in a number of diseases, for example, tuberculosis and syphilis, the entire body is hematogenously infected.

Treatment is based on an integrated approach and consists of surgical intervention in conjunction with the prescription of antibacterial and immunostimulating drugs. The presence of a common infectious disease implies the need for its priority treatment.

Osteitis of the jaw is a very unpleasant disease that can be caused by both traumatic and infectious factors, and its treatment requires the use of fairly radical medical measures.

Osteitis fibrosa

Osteitis fibrosa is one of the possible complications, which are associated with the course of the disease hyperparathyroidism, in which the bones undergo softening and deformation. Hyperparathyroidism is characterized by the fact that parathyroid hormone when it is produced in quantities significantly exceeding those required for normal functioning body. As a result, calcium-phosphorus metabolism is disrupted, and osteoclastic processes intensify, during which phosphorus and calcium are removed from the bones. At the same time, as a result of the fact that tubular absorption decreases and phosphorus begins to be released with greater activity, the occurrence of hyperphosphaturia and hypophosphatemia is noted.

Changes affecting bone tissue include the appearance of osteomalacia and osteoporosis.

Bones become brittle, which causes an increased susceptibility to fractures in the upper and lower extremities, and in addition to injuries to the spine.

According to the results of blood tests during that illness, high levels of calcium and alkaline phosphatase are recorded. Parathyroid hormone is also present in large quantities. Phosphorus levels are reduced. X-ray examination reveals thinning of the bones, a violation of their integrity in the form of cracks and fractures, and the formation of cysts is noted.

In most cases of fibrous osteitis, its course is not associated with the occurrence of any obvious specific symptoms; they can only appear during complications. This, however, should in no way inspire confidence that if osteitis fibrosa does not bother you and does not significantly affect your well-being, it is something that does not pose a threat to health. It, like any other disease, needs to be treated.

Condensing osteitis

Condensing osteitis is an inflammatory process that simultaneously affects all parts of the bone: the bone as such - osteitis, the periosteum, which is called periostitis, and myelitis - inflammation that develops in the bone marrow. Specific feature it is that it has a focal sclerosing nature and its course occurs in a chronic form.

The etiology of condensing osteitis is associated with the occurrence atypical reaction bone tissue in those patients with high resistance or with a low degree of infection, mainly at a young age.

This disease is most often localized in the area where the lower premolars are located. Tooth extraction does not lead to the disappearance of areas of sclerotic changes. The presence of minor rims of osteosclerosis sometimes occurs as a result of compensated occlusal overload, which is not due to a connection with inflammatory processes that previously occurred in the periodontium

The pathomorphological changes caused by condensing osteitis can be characterized as one of the successive stages by which an aseptic process develops, leading to osteoporosis, that is, bone destruction, and osteosclerosis, in which bone density increases.

Based on all of the above, we come to the conclusion that condensing osteitis is a chronic disease, which is characterized by the spread of pathological progress in large areas with the involvement of both the bone itself and the bone marrow and periosteum in the sclerosing processes. In view of this, its presence may require quite serious treatment and preventive measures.

Diagnosis of osteitis

Diagnosis of osteitis is mainly carried out on the basis of information about the condition of the bones obtained as a result of an x-ray examination.

On radiographs, osteitis looks like foci of destructive changes in compact or spongy bone substance, which vary in shape. These lesions range in size from several millimeters to centimeters. The edges are either clear or indeterminate. Sometimes the presence of an osteosclerotic reaction in the surrounding bone tissue is detected, and a shadow of a sequester is found inside the lesion itself.

Tuberculous osteitis is characterized by the fact that bone tissue exhibits predominantly a weakly expressed productive reaction, which looks like a narrow sclerotic border surrounding the focus of destruction. With osteitis of the tuberculous type, a spongy sequestration is formed.

Bone inflammation, which originates in the metaphyseal region, with an eccentrically located focus, mainly in children, can become a prerequisite for a layered or linear periosteal reaction, which is characterized by tuberculous osteitis. In this case, tomography is used for accurate diagnosis.

Diagnostic measures for osteitis also include radionuclide testing to accurately identify the location of inflammation when x-rays prove ineffective. This helps determine the location where the bone biopsy should be performed.

Specific osteitis is diagnosed using immunological and microbiological methods.

Diagnosis of osteitis is necessary to differentiate this disease as much as possible from dystrophic-degenerative cyst-like formations, cortical lacuna, limited aseptic necrosis, osteoid osteoma, chondroblastoma, eosinophilic granuloma, etc. establishing an accurate and unambiguous diagnosis is a positive factor for an effective treatment process and successful recovery.

X-ray diagnosis of tuberculous osteitis of the hip joint

The hip joint is one of the most common places in the human body where osteoarticular tuberculosis occurs. Based on this, it becomes important to identify the disease at the earliest possible stage of its development, which greatly facilitates the treatment process and minimizes subsequent complications. Diagnostic measures in many cases are carried out using x-ray examination. In particular, X-ray diagnostics of tuberculous osteitis of the hip joint is carried out.

According to X-ray data, at the most early studies signs of osteoporosis are detected, and it is possible to identify them only by comparing images that cover both hip joints. Even at the stage preceding tuberculous osteitis, the presence of changes in soft tissues may be noted, manifesting as enlarged shadows of intermuscular layers in the contours between the articular capsule and the middle and small muscles of the buttocks. There may be an asymmetrical arrangement of the pelvic bones due to the fact that the person takes incorrect position due to muscle atrophy or thickening of the joint on the affected side, or due to contracture of a painful nature.

After one and a half to two months, radiographs reveal the appearance of foci of destructive processes in bone tissue, the edges of which are uneven and unclear, and in which the presence of multiple spongy sequestra is noted.

Tuberculous osteitis occurs most frequently in those bones that form the acetabulum; this disease is less common in the femoral neck, and extremely rarely in the head of the femur. Regarding the latter, it should be noted that they are better visible on radiographs, during which the hip is abducted outward. In the acetabulum, the identification of foci of bone tissue destruction is facilitated by obtaining posterior radiographs.

In some cases, early deformation of the nucleus, ossification and enlargement of the femoral head can be detected in the patient.

X-ray diagnostics of tuberculous osteitis of the hip joint is carried out at different stages of the disease, which makes it possible to identify the dynamics of the pathological process and, based on this, if necessary, make certain adjustments to the treatment plan, which is aimed at improving the prognosis and increasing the possibility of effective treatment.

Treatment of osteitis

Treatment of osteitis consists of carrying out a set of medical measures, which are selected in each specific case based on the etiology and the reasons that they cause the development of the disease. As a rule, it is carried out surgery for the removal of affected tissues that have undergone necrotic processes - necroectomy. This method surgical treatment indicated for tuberculosis-type osteitis. In addition, sequestrectomy is performed to remove those bone fragments, called sequestra, that have separated from the bone due to disease. Segmental and longitudinal resection of bones, treatment of their cavities with vacuum and ultrasonic method, the use of supply and suction drainage.

Therapeutic treatment measures for osteitis consist of antimicrobial therapy using antibiotics and sulfonamides. As part of chemotherapy, effective antiseptics are prescribed, not excluding the use of specific ones, intramuscularly and intravascularly, orally and locally. Proteolytic enzymes such as papain, chymotrypsin, etc. are widely used.

Passive and active immunization and physiotherapeutic procedures play an important role in the treatment of osteitis. The affected limb must also be immobilized.

Thus, treatment of osteitis is mainly carried out in a hospital setting and is prescribed based on the etiology and nature of the disease, as well as the general condition of the patient. Based on the combination of these factors, the doctor makes a choice in favor of certain methods and develops the most suitable and efficient scheme medical events.

Prevention of osteitis

Osteitis in its specific form often occurs due to the presence of a number of diseases in a person, such as syphilis. Tuberculosis, etc. In this case, the entire body becomes infected through the hematogenous route through the blood flow in the circulatory system. The infection also enters the bone tissue, where it provokes inflammation.

Thus, the prevention of osteitis presupposes the primary need to take the necessary medical measures aimed at treating this main infectious disease. Great importance here is to begin treatment as soon as possible in short time from the moment the corresponding infection is detected in a person. Early start treatment goes a long way toward preventing its widespread spread.

In order to prevent osteitis of traumatic origin, this involves, first of all, carrying out primary treatment of an open fracture, as well as persistent adherence to the principles of observing the strictest aseptic conditions during osteosynthesis of closed fractures.

To summarize what the prevention of osteitis should be, we emphasize two basic principles. First of all it is a necessity compulsory treatment acute forms of diseases in order to prevent their transition to chronic form. And another indispensable condition is appropriate sanitation in case of damage to the integrity of bones in cases of impacts, injuries, bruises and fractures, especially open ones. To avoid getting hit pathogenic microorganisms and infections.

Osteitis prognosis

The prognosis of osteitis, in the case when appropriate rational treatment is started in a timely manner when it is detected, is predominantly favorable.

It is important to know!

Periostitis of the leg can be acute, subacute or prolonged for a long time. In addition, one should distinguish following forms pathologies, the division of which is based on causative factor, structural changes and clinical manifestations diseases.

Osteochondral exostoses are considered congenital pathologies. But they begin to grow actively under the influence of provoking factors. This happens especially often in adolescence. Most exostoses do not cause pain or other discomfort to the patient. But exostosis of the calcaneus is a little different from them. This pathology can appear at any age. The peculiarities of the location of the growth lead to severe pain, which often makes normal human movement impossible.

Features of the pathology

Exostosis is a pathological proliferation of osteochondral tissue caused by increased deposition of calcium salts, rapid skeletal growth or other provoking factors.

Such a growth, or, scientifically, osteochondroma, consists of cartilage cells and grows on the surface of the bone. It can have different shapes and grows to a size of 1.5-2 cm. If it does not compress the surrounding tissues and does not cause pain, it is not touched. But in the area of ​​the heel bone, exostosis usually makes walking very difficult. AND the only treatment This pathology is surgical removal of the growth.

The growth of bone tissue in the heel area can be localized on its plantar part or behind. In this case, even a small formation interferes with walking and causes severe pain, as it irritates the surrounding tissues. If it is mushroom-shaped, it can compress the nerve plexuses, which will lead to numbness of the foot and loss of skin sensitivity; a semicircular growth always causes severe pain, and a linear growth in the form of a spike damages soft tissues and leads to the development of inflammation.

At the initial stage, pathology is very difficult to detect. As long as it does not cause pain or changes in soft tissues, patients do not even see a doctor. The growth itself first consists of cartilage tissue, so it is not visible on x-ray. Gradually, dense bone tissue forms inside the soft shell of hyaline cartilage. Exostosis increases due to the proliferation of cartilage tissue. This distinguishes it from osteophytes, which are sharp bone growths that most often form in the joint area. They also form on the heel, but always after prolonged inflammation or injury.

Varieties

Often, osteochondral exostosis on the plantar part of the heel is called “ heel spur" This name has taken root among patients, although a “spur” is more of an acute osteophyte growth. And exostosis is an osteoma of bone and cartilage tissue. In addition to the plantar surface, such a growth can form on the upper part of the heel tubercle. This pathology is also called posterior calcaneal exostosis, or Haglund’s deformity.

According to their structure, such formations can be of several varieties:

• hard osteoma is a layer of bone tissue on the surface of the bone;
• spongy osteoma consists mainly of soft cartilaginous tissue, it can be spherical or mushroom-shaped;
• medullary osteoma contains bone marrow and does not form on the heel.

Causes

In most cases, osteochondral exostosis develops in those patients who have hereditary predisposition or any congenital pathologies of bone and cartilage tissue. But in the first years of life, growths do not form. They begin to grow under the influence of provoking factors. This could be due to injury or increased stress on the foot. Therefore, growths often form in athletes, ballerinas or people who work on their legs. It has been noted that women are more predisposed to the appearance of exostosis of the calcaneus.

Most often, exostosis occurs for the following reasons:

• after a calcaneal injury that leads to severe inflammation or abnormal cell growth;
• constantly wearing a tight uncomfortable shoes, frequent walking high heels or on a completely flat sole;
• heavy weight and other increased loads on the foot;
• flat feet or hallux valgus;
• circulatory disorders leading to deterioration of tissue nutrition;
• impact on cartilage tissue of infections - syphilis, gonorrhea, influenza, osteomyelitis, periostitis;
• endocrine diseases and disorders metabolic processes.

Symptoms

The osteochondral formation on the heel grows gradually. Usually, until it reaches a size of 1 cm, it does not cause any discomfort. If the growth is large, it can already be felt and even noticed. Such a compaction can form on the back of the heel bone or on its plantar part. But in any case, the growth greatly interferes with walking.

Most often, patients go to the doctor because of pain. They are strongest in the morning or after prolonged immobility. Then they calm down a little. And with increased physical activity, they intensify again in the evening. If the size of the growth on the plantar surface is more than a centimeter, it causes severe pain when walking. Therefore, patients are often forced to use a cane.

In addition to pain, due to constant irritation by the growth of soft tissues, swelling develops, and inflammation of the ligaments and tendons often occurs. For example, plantar fasciitis is a natural consequence of exostosis on the plantar part of the heel. The Achilles tendon is also often inflamed. The skin over the growth becomes rough, and calluses appear. Hyperemia is often noticeable, and this area is painful on palpation.

Constant pain can lead to deformation of the fingers, impaired functioning of the joints, and the development of flat feet. The consequences of the pathology are also numbness of the skin of the foot, a tendency to fractures and dislocations of the joint.

Treatment

Some patients, especially older ones, do not consult a doctor with this pathology, preferring to relieve pain on their own. This approach threatens with many complications, the most serious of which is the degeneration of tumor cells and its transformation into a cancerous tumor.

After all, exostosis very rarely disappears on its own; only in adolescence is it possible to reduce the growth. But usually the pathology gradually progresses, the formation grows, increasingly irritating the surrounding tissues.

Therefore, it is very important to consult a doctor promptly if heel pain occurs. After all, treatment of exostosis is only possible surgically, no medicines or folk methods will reduce the growth. They have only a symptomatic effect, alleviating the patient's condition. At the same time, constant surveillance behind the growth of education to prevent complications.

In addition, it is very important to eliminate the causes that led to the increased proliferation of osteochondral tissue. Without this even after surgical removal After some time, the growth may form again.

Operation

The only way to get rid of osteochondral growth is through surgery. But the operation is not performed on all patients with this pathology. Indications for surgical treatment are severe pain, development of inflammation, and rapid growth of formation. Surgery is also necessary if the growth interferes with walking or prevents you from wearing regular shoes.

The operation is performed under local anesthesia. Often the patient has many growths. In this case, only the largest ones and those that compress the surrounding tissue are removed. After anesthesia, a small incision is made and the growth is removed. After this, the surface of the bone is smoothed and a cosmetic suture is applied. The operation is considered uncomplicated, so the patient’s full return to normal life occurs within 1-2 weeks.

Conservative treatment

If the growth is not yet very large and does not cause much discomfort, symptomatic treatment is possible. Its task is to eliminate pain, swelling and inflammation. First of all, it is necessary to avoid trauma to soft tissues. For this purpose, choose comfortable, preferably orthopedic shoes. You can place a special insole or felt pads under the heel. This will help reduce pain when walking. In addition, it is recommended not to stand for long periods of time.

To relieve pain, you can use non-steroidal anti-inflammatory drugs in the form of tablets or ointments. Diclofenac, Ibuprofen, Ketoprofen, Voltaren gel or Dimexide solution are especially good for pain relief. Sometimes it is necessary to carry out a blockade by introducing it into the heel area hormonal drugs: “Hydrocortisone”, “Diprostpan” or “Kenalog”.

Physiotherapy procedures are effective for relieving inflammation of soft tissues and ligaments. The most commonly used are:

• warm foot baths, best with healing mineral water;
• foot massage;
• physiotherapy;
• electrophoresis with potassium iodide or Novocaine;
• shock wave therapy;
• ultrasound;
• magnetic therapy;
• laser heating;
• cryotherapy.

Traditional methods

At the initial stage, if the pain is not severe, and the growth does not compress the nerves and does not interfere with blood circulation, it is possible to use traditional methods. They will help relieve pain and reduce inflammation. Most often, various compresses, ointments, and foot baths are used for this. The compresses should be warming, so the leg is wrapped in polyethylene. In addition, for better penetration medicinal substances It needs to be steamed first. After using foot baths it is useful to do iodine grid on the sore spot and wear warm socks. It is better if the procedure is carried out at night.

• A fat compress will help relieve pain and soften rough skin. You can use bear, badger or pork fat. This compress is applied at night.
• Grate raw potatoes and apply to the sore spot. Wrap and keep for 4-5 hours.
• The following composition for compresses is effective: 100 ml of aloe juice, the same amount of alcohol, a bottle of valerian, half a teaspoon of red pepper and 2 tablets of Aspirin and Analgin. The composition is mixed well and infused in a dark place for 2 weeks.
• It’s good to make a compress of medical bile at night.
• Foot baths with salt effectively relieve fatigue, swelling and pain. Make a strong brine from 5 liters of water and 1 kg of salt. You can add a few drops of iodine or soda.
• Clay baths help remove salts and relieve inflammation.
• Massage with coarse salt is useful. To do this, a kilogram of salt needs to be heated and sprinkled on a flat surface. You need to walk on warm salt with bare feet.

Oral products can also be used. They are needed to normalize metabolic processes, nourish bone tissue, improve blood circulation and strengthen the immune system. For this purpose, it is best to use a tincture of cedar grains along with shells in vodka or a tincture of lilac flowers.

To prevent the growth of bone tissue on the heel, it is necessary to avoid increased stress, wear comfortable shoes, and treat pathologies of the musculoskeletal system in a timely manner. During adolescence, you need to be regularly examined by a doctor in order to detect this disease in time. Then it can be cured without complications.

Inflammation of hard bone tissue, or osteitis, can develop as a result of infection. The process that occurs as a result of the invasion of microorganisms into bone tissue can be almost invisible. But even in this case, the disease cannot be called mild.

How does osteitis manifest itself?

Doctors distinguish between specific and nonspecific inflammatory processes. In the first case, the pathogen usually causes a completely different disease (tuberculosis, syphilis, and very rarely, gonorrhea). Getting into the bone tissue with the blood, microorganisms begin their destructive activity there too. The essence of inflammation is the work of leukocytes, which try to fight pathogenic microflora.

With nonspecific osteitis, bacteria penetrate the bone from the outside. In case of an open fracture, injury accompanied by a violation of integrity skin and muscles, microbes enter directly into the tissue adjacent to the bones. This can also happen when surgical wounds are treated incorrectly, when teeth are removed and other medical procedures, produced in violation of aseptic requirements.

Sometimes osteitis develops after closed injuries (fractures, etc.), if for some reason the hematoma does not resolve. Decomposing blood clots within tissues can cause chronic local inflammation, spreading to the bone.

With asymptomatic osteitis, the patient may for a long time not noticing the presence of the disease. In some cases, this leads to sudden bone fractures in the area destroyed by the disease. Sometimes inflammation of bone tissue is detected by x-rays or similar methods of examination for other diseases.

Types of bone inflammation

Osteitis can affect any bone, so doctors distinguish many of its varieties:

1. Maxillary. It affects the bone tissue around the diseased tooth, can occur as a result of a jaw fracture and is characterized by severe pain and swelling.
2. Alveolar osteitis. It can occur after tooth extraction as a result of bacteria entering the wound.
3. Condensing. It affects different parts of the skeleton and can lead to osteoporosis, osteomyelitis and other serious chronic diseases.
4. Paget's disease, or osteitis deformans. It often affects older people and is characterized by destruction and chaotic growth of bone tissue.
5. In BCG osteitis, inflammation has different localization and is caused by Mycobacterium tuberculosis.

There are other types of the disease. Among them there are those that provoke pain over the affected bone, its destruction and swelling of the soft tissues. They are usually classified as acute osteitis. The chronic form can occur with a minimum of symptoms and be invisible externally, but leads to the proliferation of bone tissue and skeletal deformation.

Symptoms

Pronounced and rapidly increasing symptoms are characteristic of acute form inflammatory process. In this case, the patient may complain of severe pain in the area of ​​the affected bone. When the inflammatory process takes over the joint area, its mobility also decreases. When the spine is damaged, it becomes painful for a person to walk and sit.

Other symptoms are characteristic of any inflammatory process:

• hyperemia of the skin on the projection of the area of ​​the affected bone;
• local increase skin temperature;
• rapidly increasing swelling of soft tissues in the area of ​​the diseased bone;
• increase in general body temperature to significant values;
• symptoms of body intoxication (headache, nausea, chills, etc.).

If such signs of the disease occur, the need to visit a doctor arises by itself. But in the case of chronic osteitis, a person has no idea about his condition for years. But the success of its treatment depends on the timely detection of the disease.

Diagnosis of osteitis

Among the methods for diagnosing osteitis, radiographic studies occupy a leading place. The images clearly show the affected areas of the bones, which may not cause any harm to the patient. painful sensations. Using an x-ray, the doctor is able to determine the size of the inflammation and the stage of the process. Therefore, if you recommend doing a series of tests, you should not refuse this.

In children, bone inflammation is often tuberculous in nature. Koch bacilli can attack an organism with reduced immunity.

Sometimes infection with osteitis occurs after BCG (age-related vaccination against tuberculosis). But there are usually no obvious symptoms; the child only complains about constant pain in the joints of the arms and legs. Osteitis thoracis may be noticeable as a painful lump on the rib. If such signs appear, the best solution would be to visit the pediatrician and have the child examined.

Blood and urine tests may be needed to diagnose and confirm the diagnosis in children and adults. The specialist may refer the patient for a bone biopsy. At the same time, the patient undergoes various tests for the presence bacterial microflora And immunological studies. Only in this case can the disease be correctly identified and adequate treatment prescribed.

Treatment and prognosis of the disease

Osteitis can only be treated with clinical settings. By self-medicating, a person only aggravates his condition, wasting time and allowing the process to develop.

Official medicine is able to stop inflammation and eliminate its source in order to prevent the recurrence of the disease.

Surgical methods are used to treat affected bones, such as:

• necroectomy - involves the removal of decaying bone tissue;
• sequestrectomy - used to remove parts separated from the bone;
• sanitation - involves cleaning the cavity from pus.

Ultrasonic treatment of cavities, drainage of the lesion and the use of modern antibiotics to suppress the development of bacteria. This is followed by a course of maintenance therapy and related methods (physiotherapy, taking vitamins, etc.).

After discharge from the hospital, the patient must perform the procedures prescribed by the doctor. An exception may be the reception herbal decoctions stimulating the patient's immunity. All such remedies can be used only after consultation with your doctor and with his approval.

If treatment is carried out correctly and started on time, the prognosis of the disease is favorable. With severe destruction of bone tissue, the patient’s quality of life can significantly decrease.

Osteitis does not apply to life-threatening diseases, but can provoke the development of severe complications if left untreated. In the same time adequate therapy can completely eliminate the source of inflammation and lead to the patient’s recovery.

Treatment of inflammation of the joints of the fingers

Any inflammatory process that affects joint structures is called general term– arthritis. To appear this pathology maybe according to various reasons. Accordingly, the etiology of this disease will determine the methods of treatment.

For infectious diseases, the use of antibiotics is mandatory; gout requires the use of drugs that reduce the level of uric acid in the blood.

• What is arthritis?
  • Classification of arthritis on the fingers
  • Diagnosis of arthritis in the fingers
• • First aid for arthritis
  • How to treat arthritis using traditional methods?

Therapy for arthritis of the joints of the fingers with rheumatoid symptoms will be effective only with the use of immunosuppressive drugs. It is for this reason that before prescribing therapy, a rheumatologist must identify the pathogenesis of the origin of the disease. Arthritis in the fingers can be completely cured only by dealing with the cause of the inflammation.

What is arthritis?

Arthritis on the fingers is an inflammatory pathology of the periarticular or articular tissue. Under the influence of inflammation, the tissue of the joint cartilage gradually breaks down, becomes pliable and thins. The cause of arthritis can be completely different, from immune disorders to the common cold.

Diagnosing the disease involves not only identifying the pathology and level of destruction of joint tissue, but also determining a clear clinical picture. The rheumatologist needs to initially find out what exactly is causing the inflammation process.

Correct treatment of the disease at the first stage, as a rule, makes it possible to achieve complete remission. A positive prognosis will depend on proper identification of the factors that provoked the inflammation.

Classification of arthritis on the fingers

Rheumatoid arthritis is an autoimmune incurable disease. Basic distinctive feature disease is its symmetry. When the joints on the right hand are affected, similar symptoms certainly occur on the left.

This disease is characterized by rapid development. Deformation of fingers during rheumatoid arthritis without use medical supplies comes on pretty quickly. Therefore it is traditionally used conservative treatment a disease that is designed to reduce pain and stop the rapid pace of development.

The most difficult types of rheumatoid arthritis to treat are:

Treatment of arthritis of the fingers with traditional methods for rheumatoid arthritis is ineffective. To stop the progression of the disease and tissue destruction, it is necessary to use special antirheumatic drugs. But with the help herbal tinctures and other options folk remedies this disease can be effectively combated.

Diagnosis of arthritis in the fingers

All clinical symptoms arthritis, taking into account their etiology, are written in the international classification of diseases. Depending on the factors and manifestations of the disease, code 10 is assigned according to the ICD. International classification allows the rheumatologist to prescribe the most effective treatment.

After the patient contacts, the doctor collects anamnesis and conducts a general examination. During diagnosis, the main attention is paid to the following characteristic signs:

To accurately perform differential diagnosis, the patient is sent for clinical trials. Based on their results, it is possible to determine the provoking factor of inflammation. During bruises, tests may not detect any characteristic changes other than the presence of inflammation. Gout is clearly identified by the presence in the blood large quantities uric acid.

It is impossible to independently establish a diagnosis and determine treatment. For example, complications of a dislocated finger can easily be classified as gout. Differential diagnosis makes it possible to clearly establish the type of arthritis, which end result increases the effectiveness of prescribed treatment.

How to treat inflammation of the fingers?

After determining the type of arthritis, the patient is prescribed medication. It pursues a number of objectives:

First aid for arthritis

Effective treatment of arthritis is possible only in a specialized medical institution. However, you can perform first aid at home and reduce pain symptoms.

For these purposes, an ointment is used, which contains one of the following components:

• NSAIDs.
• Red pepper extract.
• Snake or bee venom.

If allergic arthritis occurs, then ointments should be used carefully, having previously passed an allergy test for the substances contained in the drug. Treatment of allergic arthritis of the fingers is also complicated by the fact that most of the antibiotics that are required for this diagnosis can also cause an allergy attack.

How to treat arthritis using traditional methods?

Folk methods also provide many effective recipes in the fight against this disease, when the joints of the fingers begin to become inflamed:

All folk methods can only be used as a temporary or preventive measure. To prevent negative consequences even in the early stages of the appearance of arthritis in the joints of the fingers, it is necessary to seek specialized assistance to the appropriate medical facility.

Most common cause the occurrence of inflammatory reactions is a bacterial infection. Inflammations can also develop due to the influence of physical or chemical factors.
Nonspecific inflammatory reactions The body is caused by various irritants, and specific inflammation is spoken of when it is caused by a very specific pathogen (for example, Koch's tuberculosis bacillus).
Bacterial inflammation in the skeletal area occurs as follows:
- direct infection of bones through open wound
- spread of the process from a neighboring focus of inflammation
- bacterial infection of bones from a distant source of inflammation through hematogenous or lymphogenous routes. Clinical picture. There are general and local symptoms of inflammation. General symptoms: malaise, weakness, increased body temperature, as well as characteristic changes in the picture peripheral blood. Local symptoms: local increase in temperature in the affected area, redness of the skin, swelling and local pain with limited function. Inflammation in the joint area is characterized by effusion into the affected joint.
The course and duration of inflammation depend on the amount, type and degree of toxicity of the pathogen or irritant, as well as on the condition protective forces and reactions of the body as a whole or its individual tissues.

Treatment of inflammatory diseases of bones and joints

There are general and local therapeutic measures. The first include: bed rest and administration of medications (eg, antibiotics and sulfonamides). Local measures: immobilization of the affected part of the body, suppression of inflammatory phenomena (alcohol compresses), surgical interventions (opening abscesses), as well as local administration of drugs.

Acute hematogenous osteomyelitis

Etiology of acute hematogenous osteomyelitis

. The cause of this disease is always an infection (for example, purulent inflammation middle ear), which spreads throughout blood vessels.

Clinic of acute hematogenous osteomyelitis

The disease begins suddenly with chills and high body temperature, often accompanied by vomiting and severe malaise. Mainly children and adolescents are affected. Depending on the state of the body’s defenses and reactions, the type and number of pathogens, a general infection may occur with fatal, the disease can acquire chronic course, cases of abscess formation are also observed. The bacteria metastasize predominantly to areas of bone located near joints, which are particularly well vascularized. Then the local symptoms described in section 8.1 develop. Purulent discharge from the cavity of the medullary canal can come out and lift the periosteum, thereby causing necrosis of the exposed bone, which is subsequently rejected in the form of a fragment (sequestrum).

Treatment of acute hematogenous osteomyelitis

Treatment includes the prescription of antibiotics, surgical opening of the source of the disease to drain accumulated pus, and removal of the sequestrum. The affected area must be immobilized. When a defect forms in the skeleton, after the disappearance of inflammatory phenomena, appropriate orthopedic means are used until conditions are created to promptly ensure the stability of the affected bone.

Chronic osteomyelitis

Etiology. The purulent pathogen affects the bones, penetrating through an open wound or from a neighboring inflammatory focus, and a transition from an acute process to a chronic one may occur.
Clinic. The disease can occur without significant changes in the general condition with minor local reactions. Tubular fistulas often form between the bone and the surface of the skin, through which pus flows, and sometimes small sequesters are torn off, which weakens the stability of the bone.
Treatment. Conservative methods are often insufficient and surgical intervention is required. Along with general antibiotic therapy, their local administration is often necessary. The affected area should be immobilized using appropriate orthopedic devices.

Tuberculosis of bones

We are talking about a specific inflammation caused by a special type of tubercle bacilli.

Etiology of bone tuberculosis

Pathogens are transferred to the skeleton from another site (most often from the lungs) through blood vessels or lymphatic tracts.

Bone Tuberculosis Clinic

This disease affects all parts of the skeleton, but especially often areas of bones near the joints, which are well supplied with blood. Since we are always talking about a general disease of the body, local symptoms are of secondary importance. Bone tuberculosis is confirmed based on the isolation of the pathogen.
Bone tuberculosis was previously very widespread, but now, thanks to intensive preventive measures and improved living conditions, it has become a rare occurrence. A significant contribution was made by systematic fluorographic examinations of the lungs, allowing for early diagnosis, and, consequently, the beginning timely treatment, due to which the dispersion of pathogens in the body is significantly prevented. Anti-tuberculosis immune therapy must be carried out within the time limits established by law.

Treatment of bone tuberculosis

Treatment is primarily aimed at eliminating the general disease, so measures to strengthen the body’s defenses are very important. The affected area of ​​the body should be immobilized. Along with specific anti-tuberculosis therapy, anti-inflammatory measures are carried out. It should be noted that treatment is long-term, and breaks in its implementation can cause relapses. Only after all symptoms of the disease have disappeared can you gradually increase the load.
Recovery often occurs with the development of defects in the bones and joint deformities, which can lead to degenerative changes. In such cases, provision of auxiliary orthopedic means is indicated.

Syphilitic diseases of the skeleton

We are talking about a chronic specific disease of an infectious nature.

Etiology of syphilitic diseases of the skeleton

The disease is caused by the causative agent of syphilis and is transmitted through sexual intercourse. Congenital forms(infection from a sick mother) are now practically not as important as they used to be.

Clinic for Syphilitic Skeletal Diseases

The course of the disease has several stages, changes in the skeleton occur in the last (3rd and 4th stages). For orthopedics, only tabetic arthropathy is important: due to changes in the spinal cord, they develop muscle hypotonia, movement disorders, “own” reflexes decrease, resulting in an unstable, staggering gait. Serious disorders can occur in the joints of the lower extremities that experience significant stress.

Treatment of syphilitic diseases of the skeleton

Treatment mainly consists of the use of special orthopedic devices, orthopedic shoes or inserts for commercially available shoes to relieve stress on damaged joints.

Inflammatory rheumatic diseases

We are talking about hypersensitivity reactions (allergy) of mesenchymal cells to various irritants. The etiology is still far from clear; it's possible that we're talking about about immunopathy (autoaggressive disease). Clinical picture. Acute rheumatic fever often develops after a sore throat. It usually begins with chills, fever, painful redness and swelling of large joints, and severe malaise. The inflammatory process involves the heart (endocardium) and kidneys, which largely determines the prognosis for this disease.
Progressive chronic polyarthritis develops slowly and has a chronic course, which additionally affects the small joints of the hands and feet. As a result of wrinkling of the capsule and destruction of the joints, the fingers and toes, as well as the joints, are gradually deformed.
Treatment: They use anti-inflammatory medications (Delagil, gold preparations, cytostatics, penicillamine) and painkillers that also have anti-inflammatory properties such as methindol, butadione and prednisolone. Physiotherapeutic activities, as well as orthopedic devices, providing the desired position and correction, should be aimed at preventing or eliminating contractures. Surgical removal inflamed synovial membrane(synovectomy) in the early stages of the disease and subsequent plastic surgery in last years are becoming increasingly important.

Bechterew's disease

The disease is characterized by progressive ankylosis of the spinal column.

Etiology of ankylosing spondylitis

The cause of the disease has not yet been established. Clinical picture. The disease develops mainly in men aged 20-40 years. It usually begins with the appearance of uncharacteristic back pain. Starting from the sacroiliac joints, progressive ossification of the entire spinal column and adjacent joints begins. Due to the immobility of the costovertebral joints, the vital capacity of the lungs is sharply limited. The disease occurs in attacks, gradually progressing, and remissions may occur.

Treatment of ankylosing spondylitis

Complete recovery is impossible, therefore methods are used that delay the progression of changes and deformations of the spinal column. For this purpose, carry out therapeutic exercises, prescribe physiotherapeutic procedures, deep X-ray irradiation, radioisotope agents, and if large joints are affected, their endoprosthetics is indicated.

Osteitis deformans (Paget's disease)

There is a chronic inflammatory deforming process of bone tissue of unknown origin. Bones become soft and deformed under stress. The tibia, femur, pelvis and skull bones are predominantly affected. spinal column. Caudal therapy is not possible. To prevent deformities, orthopedic devices and corsets are used. With the help of physiotherapeutic measures, pain can be reduced. For significant deformities of the limbs, corrective osteotomies are indicated.

Osteomyelitis is a purulent-inflammatory process in the bone marrow canal and surrounding tissues. The pathology is difficult to cope with even with the use of the most modern antibiotics. This disease causes severe complications and sometimes leads to fatal outcome. The source of inflammation can have different localization, but osteomyelitis of the lower extremities is especially common.

The disease is caused by penetration into bone structures infectious agents (germs, viruses, fungi), is a consequence of injuries or inflammatory processes of various origins.

According to medical statistics infectious process It often affects the lower extremities, as they bear a greater load. Any injury can lead to secondary tissue infection, if not timely assistance. In addition, the bones of the legs have their own structural features and blood supply, which contribute to rapid development pathology.

The process of inflammation of bone tissue occurs approximately the same for any type of pathogen. But most often osteomyelitis causes Staphylococcus aureus, less commonly streptococci, Escherichia coli, Pseudomonas aeruginosa. The main causes of the disease are the following:

• injuries;
• surgical operations, in particular joint replacement;
• arthritis with the presence of purulent effusion in the joint space;
• purulent foci in any organ, including the skin;
• infectious diseases - scarlet fever, syphilis, tuberculosis.

Direct damage to bone tissue with microbes entering it is possible, but often the infection is introduced through the blood or lymph. The source can be a boil, abscess, tonsillitis, that is, any purulent inflammation in the body.

The following predisposing factors for the occurrence of osteomyelitis have been identified:

• state of immunodeficiency;
• elderly age;
• diabetes mellitus with manifestations of polyneuropathy;
• atherosclerosis of blood vessels of the lower extremities;
• chronic diseases internal organs; in the stage of subcompensation;
• oncological problems;
• alcoholism and smoking;
• chronic venous insufficiency;
• frequent hypothermia and stressful situations;
• presence of common allergies.

If the disease develops against the background of diabetes mellitus and vascular pathology, it is difficult to treat and, as a rule, becomes chronic with frequent exacerbations and complications.

Main forms of the disease

There are several classifications of osteomyelitis , which are based on various principles.

Depending on the source of infection and the route of its penetration, the following forms are distinguished:

• hematogenous;
• post-traumatic, including gunshot and post-operative;
• odontogenic.

According to the prevalence of the process, generalized and local variety diseases. The generalized form most often leads to death and life-threatening complications.

According to the nature of the pathology, acute and chronic varieties are distinguished.

In addition, there are atypical species: Brodie's abscess (sluggish, intraosseous focus of inflammation), Garre's sclerosis, Ollier's albuminous osteomyelitis. They occur without obvious clinical symptoms and manifest themselves against the background of a sharp decrease in immune defense.

The leaders in the frequency of detection of inflammatory foci are:

• thigh - 40% of cases of infection;
• tibia - 30%.

Segments of the foot and pelvis are affected relatively rarely, accounting for 3% of cases of the disease in the overall structure of osteomyelitis.

Symptoms of osteomyelitis of the lower extremities

The initial signs of the disease are usually not specific and may resemble a common cold. At the same time, a person’s temperature rises, appetite worsens, and muscle pain appears. The malaise is gradually increasing. Local symptoms appear:

• severe pain syndrome of a local nature - gnawing, bursting pain, resistant to the action of painkillers, intensifying at night and with exercise;
• redness of the skin over the affected area, increased local temperature;
• swelling of the soft tissues in the area of ​​the inflammatory focus, which quickly increases and gradually spreads to the entire segment of the limb.

Local changes occur in the background common manifestations intoxication: severe fever, headache, nausea, vomiting, hypotension, arrhythmia.

Pus gradually accumulates, causing detachment of the periosteum. The release of enzymes that decompose tissue by microbes continues. Therefore, fistulas are formed, through which the accumulated purulent exudate is released. This gives relief to the patient, the pain becomes less intense.

When it becomes chronic, the manifestations of the disease change. Intoxication is less pronounced, the temperature rises only during exacerbations. Local symptoms consist of periodic discharge of purulent contents from the fistulous tract, which leads to an improvement in well-being.

Almost half of all cases of osteomyelitis of the lower extremities are reported due to trauma.

Every tenth patient initially applied for infectious diseases or purulent lesions of the skin, soft tissues or internal organs. Approximately every fifth case of the disease is difficult to associate with any cause.

Hip inflammation

The femur can be damaged due to injury, surgery, or when microbes enter the bloodstream or lymph. The process tends to spread to adjacent joints. Therefore, patients often experience purulent arthritis in the knee and hip joint. Inflammation gradually affects not only bone tissue, but also the bone marrow canal.

Osteomyelitis of the hip joint

The causes of pathology of this localization are: fracture of the femoral neck, femur, complications during orthopedic surgery.

Osteomyelitis of the hip joint has the following symptoms:

• intense pain spreading to the thigh and the corresponding half of the pelvis;
• a sharp decrease in the volume of passive and active movements in the joint, up to their complete absence;
• pronounced manifestations of intoxication.

Conservative therapy is not effective; it can only lead to chronicity of the process. In this case, the femoral head is gradually destroyed. Severe pain deprives a person of sleep, the joint loses its function, and movements in it become impossible.

Only endoprosthetics will help restore the ability to move independently and take care of yourself.

Symptoms of damage to the lower leg and knee joint

The most common cause of infection is traumatic injuries. The tibia is usually the site of fractures. Osteomyelitis of the knee joint can also occur after endoprosthetics if antiseptic rules are violated or the patient’s immune system is reduced.

As pathology develops, the following signs appear:

• pain in the affected area of ​​the leg;
• muscle spasm, forcing the patient to keep the limb in a bent position;
• hot, swollen and red skin over the site of inflammation;
• severe symptoms of intoxication.

Gradually, the process involves the fibula. Inflammation of the knee and ankle joint occurs most demonstrably in older people.

Osteomyelitis of this localization is characterized by a tendency to become chronic. Over the years, a person's lower leg and knee become deformed, movements become painful and limited, and the leg becomes shorter.

Inflammation of the ankle and foot

Osteomyelitis of the foot most often develops in people suffering from diabetes mellitus. With insufficient correction of blood sugar levels, diabetic polyneuropathy develops. In this case, sensitivity in the foot area is impaired and Achilles reflexes are reduced.

Against the background of significant changes in metabolism and microcirculation, trophic ulcers are formed. The necrotic process usually involves not only soft tissues, but also the heel and metatarsal bones. The phalanges of the fingers are often affected.

Diagnosis of the disease

If osteomyelitis is suspected, the diagnostic process should be carried out as quickly as possible and include the following steps:

• survey, analysis of complaints and dynamics of pathology development;
• examination of the patient;
• laboratory data ( general tests blood, urine, biochemical analysis blood);
• results instrumental examination(x-ray, MRI, ultrasound);
• determination of intraosseous pressure (in case of inflammation it exceeds 75 mm Hg);
• bone marrow puncture to obtain purulent exudate;
• radioisotope scanning.

Modern approaches to therapy

Therapeutic tactics depend on the following circumstances: the etiology of the process, the pathogenicity of the isolated pathogen and its resistance to therapy, the patient’s age, concomitant diseases and the presence of complications.

Therapy should be combined: medication, surgical care, physical therapy and other auxiliary methods

Conservative treatment

In any case, the patient is hospitalized, undergoes a thorough examination and is under medical supervision throughout healing process. Limb immobilization is mandatory.

After isolating the pathogen and checking the resistance of the microbe to the prescribed drugs, antibiotic therapy is used. Priority is given to drugs that can penetrate bone tissue. Fusidine, Ceftriaxone, Lincomycin, Vancomycin are often used. Depending on the severity of the condition, the drugs are administered intramuscularly, intravenously and into the bone marrow canal. Usually, treatment courses last at least 30-45 days, often with changes in medications .

If the use of surgical methods is impossible for health reasons, antibiotic therapy with short periods of rest continues until the end of the patient’s life.

In addition to the use of antibiotics, intensive infusion therapy With intravenous administration solutions of Hemodez, Reopoliglyukin, Albumin.

Drugs from the following pharmacological groups are also prescribed:

• antiseptics - for local treatment and intraosseous administration;
• anesthetics - to relieve pain;
• non-steroidal anti-inflammatory drugs (Diclofenac, Movalis);
• hyposensitizing drugs (Pipolfen);
• immunomodulators, including specific immunoglobulins.

Physiotherapy is performed in preparation for and after surgery. During the recovery period, physical therapy is necessary.

Surgical methods

It is very rare to cure pathology using conservative methods; you have to resort to the help of surgeons. Possible the following types surgical intervention:

1. Opening and draining a purulent focus with parallel injection of antiseptic solutions into the bone marrow canal.
2. Removal of sequesters. It is mandatory when bone fragments are detected on an x-ray. Orthopedic surgeons fill the resulting cavities with grafts from the patient’s own tissue.
3. Amputation of a limb segment Especially concerns the fingers in patients with diabetes mellitus.

Also, removal of a part of the limb becomes necessary in case of long-term immobilization, infection during the installation of knitting needles and other elements of osteometallosynthesis.

Any treatment strategy must be carried out against the background of a balanced, fortified diet and good care.

Possible complications

Pathology often leads to the following negative consequences:

• bone abscess;
• chronic bone marrow phlegmon;
• pathological fractures;
• chronic sepsis with the formation of purulent foci in various organs;
• malignant degeneration in the affected area.

Forecast

Complete cure is possible only in the earliest stages of the process, which are rarely diagnosed. With absence active therapy the disease begins to progress rapidly. In this case, the prognosis of the disease is unfavorable; in adults, it sometimes results in disability due to amputation of a limb or part thereof.

A feature of the pathology is the frequent transition to a chronic form. , despite the most modern drug therapy.

The patient must understand that in many cases it is possible to get rid of a purulent focus only by resection of a part of the bone or joint.

Answers on questions

Why can diabetic foot lead to osteomyelitis?

Diabetes mellitus is dangerous due to its complications. The most common of these is diabetic foot. This damages the sensory and motor nerves. Due to decreased sensitivity, the patient may not notice for a long time the presence of a gradually enlarging wound on the leg that has arisen for various reasons.

Over time it transforms into trophic ulcer, which extends deep into the bone. Related infectious lesion leads to osteomyelitis in the heel and toes.

Which antibiotics are most effective in treating pathology?

It depends on the pathogen that provoked the inflammation of the bone marrow. Choose the drug to which the isolated microbe is not resistant. Broad-spectrum antibiotics are mainly used. They are often combined with antimicrobial drugs from other groups. In particular, ciprofloxacin from the group of fluoroquinolones is widely used.

Why does osteomyelitis of the lower extremities occur in infants?

The reason most often is the presence of a purulent focus in the body. Usually the infection enters the bones from a poorly treated umbilical wound.

Conclusion

To stop the progression of osteomyelitis of the lower extremities and maintain health, you need early diagnosis, timely adequate treatment. To prevent pathology, it is important to contact specialists when injured, treat infectious and chronic diseases in a timely manner, and undergo an annual medical examination.

Dental diseases include not only inflammatory processes occurring directly in the tooth, but also damage to the tissues surrounding the tooth - bones, periosteum or ligaments. And basically all damage to surrounding tissues leads to tooth loss.

Inflammation of the periosteum

The periosteum is the lining or connective tissue between bone tissue and tooth. Periostitis - this is an inflammation of the periosteum, also this disease is usually called “flux”. Periostitis is very easy to detect - a lump appears on the gum, usually filled with pus. Flux is a very serious disease that requires surgical intervention, but in no case self-medicate.

The reasons for the appearance of flux can be various injuries that caused hematoma of internal tissues, as well as advanced caries or incomplete dental treatment. For example, the cause of gumboil can be pulpitis, the treatment of which the patient abandoned halfway through. If the doctor did not remove the nerve, but applied, for example, arsenic or a drug, you should definitely visit the dentist again to remove the temporary filling and install a permanent one, otherwise the nerve may begin to become inflamed and even rot, which will invariably lead to inflammation of the periosteum or bone tissue.

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Periostitis: symptoms

Periostitis: treatment

• mandatory deletion carious cavity
• treatment or removal inflamed nerve tooth
• root canal treatment
• removal of a purulent source of inflammation (usually by a surgical method, which involves cutting the gums and releasing pus out)
• filling and prosthetics of damaged teeth
• used simultaneously with dental treatment drug therapy

In case of flux, you should never treat yourself! The formation of pus indicates a serious inflammatory process. With self-medication, the purulent focus can increase and spread throughout the body. Traditional methods are used only to relieve pain and facilitate the treatment process, but nothing more.

Inflammation of bone tissue

Following the periosteum is bone tissue, in which the tooth root is securely fixed. Inflammation of bone tissue is always a very serious disease that leads to the destruction of hard bone and, accordingly, tooth loss. Periodontitis is an inflammation of the bone tissue surrounding the tooth. With periodontitis, the tooth is not alive, since the bacteria first attack the root and nerve of the tooth, and only then spread to the bone tissue.

The main causes of periodontitis include dental trauma, as well as acute caries or pulpitis, in which the nerve of the tooth dies.

Periodontitis: symptoms

• sharp pain
• the presence of carious cavities on the tooth
• bad breath
• tooth mobility
• fistulas on the gums (in the most severe stages)

Periodontitis: treatment

• administration of anesthesia
• removal of carious cavities and remnants of nerve endings is an important stage in the treatment of periodontitis, since it is important to remove all microbes that cause the inflammatory process
• cleaning and antiseptic treatment tooth canals
• applying a paste that has a healing effect on bone tissue, penetrating through the tooth root
• temporary tooth filling
• If teeth are mobile, splinting may be required - that is, applying splints with inside teeth - this method, simultaneously with other treatment, will allow you to fix mobile teeth relative to the strong neighboring ones
• Along with treatment, drug therapy is carried out, which allows you to restore the structure of bone tissue and reduce inflammatory processes in the body