RESUMO
Primary osteomyelitis of the sternum is rare, especially in young adults. A 16-year-old boy was admitted to the orthopaedic department with chest pain and fever. The blood culture was positive for Staphylococcus aureus. MRI revealed a retrosternal abcess; a bone scan showed increased local uptake, suggestive of isolated osteomyelitis. Two weeks after the start of treatment with flucloxacillin 1 g 6 times a day i.v. the patient's condition had significantly improved: the pain had subsided and the fever had disappeared. In sternal osteomyelitis early treatment with antibiotics is successful and avoids complications and surgical intervention.
Assuntos
Abscesso/microbiologia , Floxacilina/uso terapêutico , Osteomielite/microbiologia , Penicilinas/uso terapêutico , Infecções Estafilocócicas/microbiologia , Esterno/microbiologia , Abscesso/tratamento farmacológico , Doença Aguda , Adolescente , Humanos , Masculino , Osteomielite/tratamento farmacológico , Radiografia , Infecções Estafilocócicas/tratamento farmacológico , Esterno/diagnóstico por imagem , Esterno/patologia , Resultado do TratamentoRESUMO
Between July 1983 and July 1986 115 patients, aged 50 years and older, suffering from 122 meniscal tears, were treated by arthroscopic surgery. Of these, 109 patients with 116 meniscectomy could be seen for a follow-up examination 2 years postoperatively. Patients of 50 years and older are known to need a long hospitalisation and a long rehabilitation period after an open meniscectomy. A quarter of all patients had a knee accident in their past as the cause of their complaints. Their main complaints are pain and swelling. As could be expected we found degenerative changes in 78% of the knees. After arthroscopic surgery the hospital stay is short, 75% is back home within 2 days. Half of the patients needed physiotherapy afterwards, 80% of all arthroscopically treated patients were satisfied. The group of patients aged 70 years and older scored worse, 50% of this group was satisfied. Two patients with severe degenerative changes on the X-rays did well. There is a positive correlation between the changes found arthroscopically and the final result.
Assuntos
Meniscos Tibiais/cirurgia , Idoso , Artroscopia , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/cirurgia , Ruptura , Lesões do Menisco TibialRESUMO
This report describes one case in which bone scintigraphy was helpful in establishing the diagnosis of osteoid osteoma and presents three other cases in which increased accumulation of 99mmTc-EHDP was found at the side of the osteoid osteoma. The study contributes to the observation by others that the osteoid osteoma occurs as a scintigraphic 'hotspot'. It is concluded that the diagnostic delay of the osteoid osteoma can be shortened when bone scintigraphy is performed more often and at an earlier stage in patients with unexplained bone pain or with a clinical history that leads to the suspicion of the presence of an osteoid osteoma.
