1/44. Recognition and significance of pulmonary bone embolism.embolism of bone marrow to the lungs is a quite frequent finding after trauma but transport and deposition of solid bone is rarely seen, which may simply be because pulmonary calcifications are not recognized as bone fragments. We report on three patients with embolism of bone spicules to small lung arteries of about 0.5 mm in diameter which were plentiful in two of the patients on postmortem examination. However, the true nature of the emboli was only recognizable after decalcification of lung tissues. It appears that trauma occurring in a septic bone lesion has the greatest chance to provoke bone embolism. The bone spicules do not usually occlude vessel lumina and thus do not severely disturb the blood circulation in the lungs. The bone fragments become covered by endothelium and can remain recognizable for months or even years.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/44. Spinal aspergillus osteomyelitis.aspergillus species are uncommon etiologic agents of vertebral osteomyelitis. We describe two patients with lumbar vertebral aspergillosis precipitated by the use of corticosteroids and review 39 cases in the literature. The mean age of the population was 40.04 years. There was male predominance (78% of cases), mainly lumbar involvement (53.7%), and monomicrobial nature of infection; 65.8% of the patients had predisposing factors, while 34.1% had none. Back pain (53.6% of cases) was the predominant symptom, while neurological deficits were present in 29.2% of the patients. White blood cell counts were elevated in 12.2% of the patients, and erythrocyte sedimentation rates were >40 mm/h in 39%. The overall recovery rate was 68.3%, and the mortality rate was 26.8%. Although aspergillus osteomyelitis is primarily treated medically, certain cases may require surgical intervention.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/44. Imaging of mucormycosis skull base osteomyelitis.skull base osteomyelitis (SBO) is typically bacterial in origin and caused by pseudomonas, although the fungus aspergillus has also rarely been implicated. SBO generally arises from ear infections and infrequently complicates sinonasal infection. Rhinocerebral Mucor infection is characteristically an acute, fulminant, and deadly infection also affecting the orbits and deep face and is associated with intracranial complications. Bony involvement is uncommon because of the angioinvasive nature of the fungus. More recently, chronic invasive Mucor sinusitis has been described. We report the unusual clinical and imaging features of a patient with biopsy-proven invasive mucormycosis arising from chronic isolated sphenoid sinus disease, who presented with extensive SBO and a paucity of deep facial, orbital, or intracranial involvement.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/44. Vertebral osteonecrosis associated with the use of intradiscal electrothermal therapy: a case report.STUDY DESIGN: This report describes a case of vertebral body osteonecrosis associated with the use of intradiscal electrothermal therapy. OBJECTIVES: To alert clinicians to a previously unreported complication, vertebral body osteonecrosis, after an intradiscal electrothermal therapy procedure. SUMMARY OF BACKGROUND DATA: The intradiscal electrothermal therapy procedure is a new treatment that has been advocated in the management of chronic low back pain of discogenic origin. The intradiscal electrothermal therapy procedure uses a fluoroscopically guided thermal catheter to heat the intervertebral disc. A review of the literature regarding this procedure has not revealed osteonecrosis as a complication. methods: The patient's work-up and postoperative course are documented, and all medical records were reviewed retrospectively. RESULTS: The patient's pain had improved only minimally at initial follow-up after L5-S1 combined anterior and posterior spinal fusion, undertaken after intradiscal electrothermal therapy failure. CONCLUSIONS: Intradiscal electrothermal therapy has gained increasing popularity in the treatment of discogenic low back pain, in large part because of its minimally invasive nature and perceived low risk for major complications. Previous reports in the literature have not noted any major complications associated with the proper use of this device. Clinicians should be advised that intradiscal electrothermal therapy can be associated with complications, which in the current case, led to osteonecrosis of the vertebral body.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/44. amputation-sparing treatment by nature: "surgical" maggots revisited.Maggots were used as adjunct treatment for infected wounds that showed no response to the classical approach of wound debridement and antibiotic therapy. We summarize findings for 11 patients with necrotic wounds who received treatment with "surgical" maggots (100-2900 applied in 3-10 changes of dressing) for 11-34 days, which apparently aided in tissue remodeling and cure, and describe 2 typical patients in detail.- - - - - - - - - - ranking = 4keywords = nature (Clic here for more details about this article) |
6/44. lung abscess and osteomyelitis of rib due to yersinia enterocolitica.The first reported case of infection of the lung and bone with yersinia enterocolitica is described. This organism has only recently been known to infect humans. Although a wide spectrum of diseases has been described, all have appeared to be relatively benign; however, in our case a rapid necrotizing process occurred. Therefore, the aggressive nature of this organism outside its usual surroundings, eg, the gastrointestinal tract, is worth noting.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/44. Subacute propionibacterium acnes osteomyelitis of the spine in an adolescent.Moderate to severe facial acne is caused by infection with propionibacterium acnes, an organism that has also been implicated in subacute osteomyelitis. The symptoms are often indolent in nature, but slowly progressive. We present a case report of subacute P. acnes osteomyelitis at our institution. A high index of suspicion and an extended incubation time are required for diagnosis. Treatment usually requires irrigation and debridement, with or without antibiotics.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/44. osteomyelitis and intervertebral discitis caused by pseudomonas pickettii.pseudomonas pickettii, a nonfermenting, gram-negative rod, is rarely pathogenic. Previous reports of infection with P. pickettii have largely involved direct contamination of supplies presumed to be sterile. We describe a case of vertebral osteomyelitis and intervertebral discitis caused by P. pickettii in a debilitated patient. The aggressive nature of this infection demonstrates that P. pickettii may be a more invasive organism than previously noted, particularly in hosts with weakened immunity secondary to underlying disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/44. osteomyelitis of the ischiopubic synchondrosis: imaging findings.osteomyelitis of the ischiopubic synchondrosis in children is not rare and presents a diagnostic problem because of the diversity of presentation and the deceptive nature of symptoms. Radiological assessment is extremely difficult because of the variation in normal ossification on radiography and normal physiological uptake on radioisotope bone scan. We present two cases of osteomyelitis of the ischiopubic synchondrosis and describe findings on radiographs, isotope bone scan, computed tomography (CT) and magnetic resonance imaging (MRI). MRI changes have not been described in any of the case reports in the English literature. Aspiration and biopsy remain the gold standard for diagnosis. However, MRI appearances can significantly increase diagnostic confidence prior to intervention.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/44. Group G streptococcus--a rare cause of osteomyelitis simulating bone tumour: a case report.We report a case of osteomyelitis of the proximal femur caused by Lancefield group G streptococcus in a 71-year-old otherwise healthy man. The organism has rarely been identified as the cause of osteomyelitis. The subacute nature of the symptoms and the radiological appearance of the femur in this patient mimic bone tumour. The patient was successfully treated with conservative methods, including a prolonged period of oral antibiotics. We stress the importance of histological and bacteriological evidence in avoiding misdiagnosing patients with equivocal clinical and radiological presentation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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