osteomielitis ppt

of 28 /28
RESPONSI OSTEOMYELITIS Pebimbing: dr. Erwien Isparnadi, Sp.OT SMF BEDAH RSU HAJI SURABAYA FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH MALANG 2015 Disusun oleh: Maulana Saputra (201410401011007)

Embed Size (px)

description

osteomielitis

Transcript of osteomielitis ppt

Page 1: osteomielitis ppt

RESPONSIOSTEOMYELITIS

Pebimbing:dr. Erwien Isparnadi, Sp.OT

SMF BEDAH RSU HAJI SURABAYA FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH MALANG

2015

Disusun oleh:Maulana Saputra (201410401011007)

Page 2: osteomielitis ppt

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 ± 5-25%.

Page 3: osteomielitis ppt

DEFINITION

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

Page 4: osteomielitis ppt

Epidemiologi

• 50% osteomyelitis occurs in children less than 5 years.

• 10-30% acute osteomyelitis progressed to chronic osteomyelitis.

Page 5: osteomielitis ppt

ETIOLOGI

Staphylococcus aureus

(89-90%)

Escherichia coliPseudomonas

Klebsiella

Page 6: osteomielitis ppt

PATOFISIOLOGI

osteomielitis

Hematogen

lokal

Page 7: osteomielitis ppt

KLASIFIKASI

Cierney dan Mader

Page 8: osteomielitis ppt

GAMBARAN KLINIS

General• Fever • Malaise• Nausea• AnoreksiaLocali• Painful• Edema• Hiperemi

Page 9: osteomielitis ppt

Diagnosis

• Anamnesis• Physical diagnostic• Radiologi• Kultur

Page 10: osteomielitis ppt

RADIOGRAFI

Reaksi periosteal osteolisis distal metatarsal IV dan distal phalanges III IV

Page 11: osteomielitis ppt

RADIOGRAFI

Deformitas femur Sklerosis sumsum

Page 12: osteomielitis ppt

RADIOGRAFI

MRI femurInhomegenitas

Page 13: osteomielitis ppt

DIFERENSIAL DIAGNOSIS

• Arthritis Supuratif Acute• Osteosarcoma

Page 14: osteomielitis ppt

Therapi

• Antibiotic• Antipiretik• Fluid• Debridement

Page 15: osteomielitis ppt

15

Page 16: osteomielitis ppt

16

Page 17: osteomielitis ppt

COMPLICATION

17

Septikemia Artritis Supuratif

Osteomyelitis Kronik

Fraktur Patologis

Page 18: osteomielitis ppt

PROGNOSIS

18

• Mortalitas osteomyelitis ± 5-25%.

• 10-30% acute osteomyelitis progressed

to chronic osteomyelitis.

Page 19: osteomielitis ppt

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

Page 20: osteomielitis ppt

ANAMNESISPain 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.

Page 21: osteomielitis ppt

Past Medical History

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

Page 22: osteomielitis ppt

Phisical Examination

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

Page 23: osteomielitis ppt

• K/L : A/I/C/D -/-/-/- , palpebral oedem (–), rinorhea (-), otorhea (-), periorbital hematome (-).

• Thorax : Pulmo: I : normochest, (-)P : symmetric expantion

P : sonor/sonorA : VBS +/+ , ronchi -/-, wheezing -/-

Cor: I : IC (-)P : thrill (-)P : cardiac border: normalA : S1S2 single, murmur (-), gallop (-)

Page 24: osteomielitis ppt

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

• Ekstremitas: AKHM +/+

+/+

Oedem -/- -/+

Page 25: osteomielitis ppt

REGIO FEMUR SINISTRA:

• Look: hyperemi (+), edema (+)ulcus (-), fistule (-), pus (-)

• Feel: calor (+), crepitate (-), pain (+)

• Move: ROM limited

Page 26: osteomielitis ppt

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

Page 27: osteomielitis ppt

– Diagnosis Planning : DL

– Diagnosis: Chronic Osteomyelitis 1/3 Femur Distal sinistra

– Therapy:

1. Wound Toilet2. MedikamentosaCefixime 2 x 100 mg and

Paracetamol 3 x 500 mg

Page 28: osteomielitis ppt