RESPONSI

OSTEOMYELITIS

Pebimbing:
dr. Erwien Isparnadi, Sp.OT

Disusun oleh:
Maulana Saputra (201410401011007)

SMF BEDAH RSU HAJI SURABAYA

FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH
MALANG
2015

PENDAHULUAN
Osteomyelitis is an inflammation of
the bone caused by a bacterial
infection.
The incidence of Osteomyelitis
range between 0,1 to 1,8% of the
adult population.

The mortality of osteomyelitis 525%.

DEFINITION
Osteomyelitis is an acute or chronic
inflammatory process of the bone
and its structures due to infection by
pyogenic bacteria.

Epidemiologi
50% osteomyelitis occurs in children
less than 5 years.
10-30% acute osteomyelitis
progressed to chronic osteomyelitis.

ETIOLOGI

Staphylococcus aureus
(89-90%)
Escherichiacoli
Pseudomonas
Klebsiella

PATOFISIOLOGI

Hematogen

osteomielitis

lokal

KLASIFIKASI
Cierney dan Mader

GAMBARAN KLINIS

General
Fever
Malaise
Nausea
Anoreksia
Locali
Painful
Edema
Hiperemi

Diagnosis

Anamnesis
Physical diagnostic
Radiologi
Kultur

RADIOGRAFI

Reaksi periosteal osteolisis distal metatarsal

IV dan distal phalanges III IV

RADIOGRAFI

Deformitas femur
Sklerosis sumsum

RADIOGRAFI

MRI femur
Inhomegenitas

DIFERENSIAL DIAGNOSIS
Arthritis Supuratif Acute
Osteosarcoma

Therapi

Antibiotic
Antipiretik
Fluid
Debridement

15

16

COMPLICATION
Septikemi
a

Artritis
Supuratif

Osteomyel
itis Kronik

Fraktur
Patologis
17

PROGNOSIS
Mortalitas osteomyelitis 525%.
10-30% acute osteomyelitis
progressed to chronic
osteomyelitis.
18

CASE REPORT

Name : Tn. Sumarno

Ages : 50 tahun
Gender : Laki-laki
Address : Tambak Pondok Legi II/B
Surabaya
Religions : Moeslem
Ethnic : Jawa
Educational : Elementary
School
Occupation : Driver
No. register : 698751

ANAMNESIS
Pain in the thigh knee

Patient came with Pain in the left thigh since one year ago, the pain
worse at late 4 month. Firstly there was knee swelling and redness
appearing on his left thight and the patient felt pain. The pain was
intermittent in late 4 months. The pain increased when the patient
walking. Patient used tawon oil but there was no effect. Sometimes
patient felt his body temperature elavated. one year ago, patient has
done fracture surgery on his left thigh.

Past Medical History

DM (-)
HT(-)
Alergic (-)
Asma (-)

Phisical Examination
General condition : Fine
Vital Sign
BP
: 120/70 mmHg
N
: 78 x/minutes
RR
: 17 x/minutes
t
: 36,30 C

 K/L : A/I/C/D -/-/-/- , palpebral oedem (),

rinorhea (-), otorhea (-), periorbital hematome
(-).
Thorax :
Pulmo:
I : normochest, (-)
P : symmetric expantion
P : sonor/sonor
A : VBS +/+ , ronchi -/-, wheezing -/Cor:
I : IC (-)
P : thrill (-)
P : cardiac border: normal
A : S1S2 single, murmur (-), gallop (-)

 Abdomen :
I : Flat, symmetric
P : Soepel, tenderness (-)
P : Tympani, meteorismus (-)
A : bowel (+) normal

Ekstremitas: AKHM +/+

+/+
Oedem -/-/+

REGIO FEMUR SINISTRA:

Look: hyperemi
(+), edema
(+)ulcus (-),
fistule (-), pus (-)
Feel: calor (+),
crepitate (-), pain
(+)
Move: ROM
limited

X-Ray
:
sklerotic distal os femur.
Osteophyte at medial condylus et
lateral tibia and supero-infero
posterior margo os patella.
Fracture (-)
Osteolitik/blastik (-)
Soft tissue swelling (-)
Chronic osteomyelitis et femur distal
S

 Diagnosis Planning : DL
Diagnosis: Chronic Osteomyelitis
1/3 Femur Distal sinistra
Therapy:

1. Wound Toilet
2. Medikamentosa
Cefixime 2 x 100 mg and
Paracetamol 3 x 500 mg