Bone and joint infection (original) (raw)
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Bone and joint infections in adults: a comprehensive classification proposal
European Orthopaedics and Traumatology, 2011
Introduction and methods Ten currently available classifications were tested for their ability to describe a continuous cohort of 300 adult patients affected by bone and joint infections. Each classification only focused, on the average, on 1.3±0.4 features of a single clinical condition (osteomyelitis, implant-related infections, or septic arthritis), being able to classify 34.8±24.7% of the patients, while a comprehensive classification system could describe all the patients considered in the study. Result and conclusion A comprehensive classification system permits more accurate classification of bone and joint infections in adults than any single classification available and may serve for didactic, scientific, and clinical purposes.
Bone infection: a clinical priority for clinicians, scientists and educators
European Cells and Materials, 2021
Bone infection has received increasing attention in recent years as one of the main outstanding clinical problems in orthopaedic-trauma surgery that has not been successfully addressed. In fact, infection may develop across a spectrum of patient types regardless of the level of perioperative management, including antibiotic prophylaxis. Some of the main unknown factors that may be involved, and the main targets for future intervention, include more accurate and less invasive diagnostic options, more thorough and accurate debridement protocols, and more potent and targeted antimicrobials. The underlying biology dominates the clinical management of bone infections, with features such as biofilm formation, osteolysis and vascularisation being particularly influential. Based on the persistence of this problem, an improved understanding of the basic biology is deemed necessary to enable innovation in the field. Furthermore, from the clinical side, better evidence, documentation and outre...
Best Practice & Research Clinical Rheumatology, 1999
Bone and joints are normally sterile areas. Bacteria may reach these sites by either haematogenous spread or spread from an exogenous or endogenous contiguous focus of infection. Bone infection, or osteomyelitis, is characterized by a progressive infectious process resulting in inflammatory destruction of bone, bone necrosis and new bone formation. Joint infections, or infectious arthritis, arise either from the haematogenous spread of organisms through the highly vascularized synovial membrane or from direct extension of a contiguous bone or soft tissue infection. The most commonly involved joints are the knee and the hip, although any joint can become infected. Infectious arthritis is monoarticular in 90% of cases. Some of the questions to be answered in this chapter include: how bacteria reach and cause damage in the bones and joints; what the current classification systems of bone and joint infections are; what some risk factors and host factors associated with bone and joint infection are; what some current characteristics of musculoskeletal infections are and whether the damage to joints can be diminished by treatment.
European Radiology
Objectives Peripheral bone infection (PBI) and prosthetic joint infection (PJI) are two different infectious conditions of the musculoskeletal system. They have in common to be quite challenging to be diagnosed and no clear diagnostic flowchart has been established. Thus, a conjoined initiative on these two topics has been initiated by the European Society of Radiology (ESR), the European Association of Nuclear Medicine (EANM), the European Bone and Joint Infection Society (EBJIS), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). The purpose of this work is to provide an overview on the two consensus documents on PBI and PJI that originated by the conjoined work of the ESR, EANM, and EBJIS (with ESCMID endorsement). Methods and results After literature search, a list of 18 statements for PBI and 25 statements for PJI were drafted in consensus on the most debated diagnostic challenges on these two topics, with emphasis on imaging. Conclusions Overall, white blood cell scintigraphy and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities for the diagnosis of PBI and PJI. However, the choice of which advanced diagnostic modality to use first depends on several factors, such as the benefit for the patient, local experience of imaging Electronic supplementary material The online version of this article (
The Journal of arthroplasty, 2018
infectious disease (ID) specialist quality of life measures (QOL) patient-reported outcomes (PROs) Question 1: Should PJI cases be referred to a regional center to improve the outcome of treatment and decrease cost? Recommendation: Yes, for probable better outcome and greater efficiency. Level of Evidence: Consensus Delegate Vote: Agree: 92%, Disagree: 6%, Abstain: 2% (Super Majority, Strong Consensus) Rationale: Periprosthetic joint infection (PJI) significantly increases the utilization of hospital and physician resources compared to primary cases or aseptic revisions [1]. There is evidence to support that primary total joint replacements performed in a specialized center may have lower complications and lower reoperations than those performed in nonspecialized centers [2]. This experience should be extrapolated for the treatment of PJIs. It is reasonable to assume One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to
The risk of developing surgical site infections (SSIs)/periprosthetic joint infections (PJIs) after total joint arthroplasty (TJA) is likely to be influenced by several factors such as the characteristics of the patients, the surgical intervention, and the postoperative care (Table 1). However, patient- or host-related factors such as sociodemographic characteristics, body mass index, and medical and surgical histories seem to play an important role in the development of SSIs/PJIs. With the exception of factors such as age and sex, many patient factors are modifiable and could potentially be used for the identification of patients at high risk of developing SSIs/PJIs as well as targeting appropriate interventions. The literature has a plethora of studies that have evaluated the associations of these potential host factors and the risk of SSIs/PJIs. However, some of the findings have been inconclusive because of inconsistent results reported. We sought to clarify the evidence by conducting a comprehensive systematic review of the literature.
Musculoskeletal infections through direct inoculation
Skeletal radiology, 2024
Musculoskeletal infections consist of different clinical conditions that are commonly encountered in daily clinical settings. As clinical findings and even laboratory tests cannot always be specific, imaging plays a crucial role in the diagnosis and treatment of these cases. Musculoskeletal infections most commonly occur secondary to direct inoculation into the skin involuntarily affected by trauma, microorganism, foreign bodies, or in diabetic ulcers; direct infections can also occur from voluntary causes due to surgery, vaccinations, or other iatrogenic procedures. Hematogenous spread of infection from a remote focus can also be a cause for musculoskeletal infections. Risk factors for soft tissue and bone infections include immunosuppression, old age, corticosteroid use, systemic illnesses, malnutrition, obesity, and burns. Most literature discusses musculoskeletal infections according to the diagnostic tools or forms of infection seen in different soft tissue anatomical planes or bones. This review article aims to evaluate musculoskeletal infections that occur due to direct inoculation to the musculoskeletal tissues, by focusing on the traumatic mechanism with emphasis on the radiological findings.