Pyogenic discitis in female after delivery and pelvic surgery

Pyogenic discitis most frequently occurs after home delivery, hemorridectomy, and dilatation and curettage. Discitis is generally due to blood borne bacterial invasion of the disc from adjacent end-plate via communicating vessels. Infective discitis remains an uncommon, but potentially serious cause for back pain. Delayed diagnosis can occur and a high index of suspicion may occur. The study included 30 patients suffering from localized low back pain with limitation of movement. Diagnosis was made by history, physical examination and investigation mainly E.S.R and MRI. 50.3% of patient with discitis had a history of vaginal delivery, 15% had a history of hemorridectomy and 10% had a history of dilatation and curettage and cesarean section surgery. All patients had elevated E.S.R, Positive C-reactive protein and positive MRI finding. We must think of Pyogenic discitis in any patient with sever backache, fever, local tenderness, and high ESR

value of early mobilization in patients with osteogenesis imperfecta

Osteogenesis imperfecta is an inherited disorder of collagen maturation which results in abnormal skeletal, ligament, skin, sclera, and dentin formation. Management includes focusing on preventing or minimizing deformities and maximizing the individual's functional ability at home and in the community. Physical therapy including early mobilization after fracture is effective in strengthening muscles which in turn, improves bone density. The theory of set-point proposal, a possible causative mechanism in osteogenesis imperfecta presents a special mechanism of skeletal intermediary organization causing many features of the disease. The minimum effective strain is abnormal in osteogenesis imperfecta, so early mobilization is important in prevention of further fractures of the limbs. The prediction of the role of early mobilization in decreasing the incident of fractures of long bones in osteogenesis imperfecta. This is a prospective study of 42 patients with osteogenesis imperfecta for ten years, they were studied and different methods and treatment used, they were divided into two groups. Group I, included 24 patients which included new patients with new fractures of femur and treated by early mobilization, Group II, included 18 patients treated by immobilization [plaster of paris]. For both groups the commonest age group was [0-2 years]. Male to female ratio was 2:1. Radiological classification mostly thick bone type. Sillence classification, mostly sillence I. In group I surgery was done for 33.3%, traction methods for 66.7%. Follow up for 2.5-3 years was done and 4.2% develop fracture in the same femur while 8.75% developed fracture the contra-lateral femur. In group II all patients treated by immobilization for 4-6 weeks using plaster of pairs, during follow up for same period 16.7% develop fracture in the same femur. And 16.7% developed fracture in the ipsi-lateral tibia. Early mobilization in patients with osteogene imperfecta proved to be a good method in preventing and decreasing the incidence of fractures in different tubular bones