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MUSCULOSKELETAL AND CONNECTIVE TISSUE DISEASES
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Systemic Lupus Erythematosus Juvenile Arthritis Scleroderma Ankylosing Spondylitis
Sjogren's Syndrome Polymyalgia Rheumatica Polymyositis Osteomyelitis
Mixed Connective Tissue Disease Paget's Disease Infectious Arthritis Osteogenic Sarcoma
Reiter's Syndrome Metastatic Carcinoma of Bone Rheumatoid Arthritis .
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OSTEOMYELITIS
Osteomyelitis is an infection of the bone that occurs most frequently in the lower extremities. Most commonly, it develops after severe local trauma with an associated open fracture. The adjacent soft tissue structures are injured together with the bone, and can form a poorly vascularized and scarred tissue bed. Simple debridement and antibiotic therapy are often unsuccessful in treating lower extremity osteomyelitis. As a result, patients frequently present after multiple failed treatments and with resistant or polymicrobial bacterial infection.

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LABORATORY FINDINGS
  • Leukocytosis, especially in acute infection;  normal WBC in chronic disease
  • Normocytic anaemia, chronic disease type
  • Increased sedimentation rate and C-reactive protein - indicates active disease
  • Decreased serum albumin and increased alpha2-globulin reflect chronic infection.
  • *Positive blood culture, especially in acute osteomyelitis in children
Culture of Infected Bone
  • Staphylococcus aureus (60%-90%) - most infections of hip, skull, vertebrae, long bones
  • Pseudomonas - frequently found in drug addicts
  • Candida, Aspergillus, Rhizopus - in patients who are immunosuppressed or receiving protracted intravenous or parenteral therapy
  • Salmonella - occurs frequently in patients with sickle cell disease
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