Zur Definition der Diagnose Osteomyelitis – Osteomyelitis-Diagnose-Score (ODS)

Schmidt, H. G. K.; Tiemann, A.; Braunschweig, R.; Diefenbeck, Michael; Bühler, M; Abitzsch, D; Haustedt, Nils; Walter, Gerhard; Schoop, R.; Heppert, V.; Hofmann, G. O.; Glombitza, Martin; Grimme, C.; Gerlach, U-J; Flesch, Ingo; Dgouc, Arbeitsgemeinschaft septische Chirugie der

doi:10.1055/s-0030-1270970

Cited by 36 publications

(32 citation statements)

References 43 publications

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“…The "golden" standard is the histological method, which is one of the five special methods for the diagnosis of osteomyelitis [6].…”

Section: Discussionmentioning

confidence: 99%

“…Tissue damage may be quite extensive in chronic osteomyelitis of the foot, involving the joints in the inflammatory process [5]. Histopathological features of bone tissue in acute and chronic osteomyelitis have been described well [6]. Most reports of pathological changes in the cartilage tissue of joints in osteomyelitis are separate descriptions of clinical cases that develop osteoarthritis and synovitis of large joints [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Structural reorganization of the cartilage tissue in chronic osteomyelitis of the foot bones

Ступина¹,

Migalkin²,

Sudnitsyn³

2019

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Purpose To study structural reorganization of the cartilage tissue of the joints, depending on the location of osteomyelitis in the bones of the foot. Materials and methods Intraoperative material of 16 patients with chronic osteomyelitis in the foot bones was studied (10 males in the average age 45.3 (33 ÷ 56) years and six females in the average age of 40 (23 ÷ 53) years). The material was resected fragments of the osteo-cartilaginous complex: calcaneus, talus and adjacent joint tissue (subtalar and talo-navicular, phalangeal and metatarsal bones and metatarsophalangeal joint). The material was fixed in 10 % formalin. Paraffin sections (5-7 μm thick) were stained with hematoxylin and eosin. Histological studies were performed using a stereo microscope "AxioScope.A1" with a digital camera "AxioCam" and software "Zenblue" (CarlZeiss MicroImaging GmbH, Germany). Results The subchondral bone plate and basophilic line remained continuous and the vessels did not penetrate into the cartilaginous tissue in chronic osteomyelitis of the calcaneus and talus, when the osteomyelitis foci were remote from the articular surface. If an osteomyelitic lesion was present in the subchondral zone, abnormalities in the articular cartilage were detected both from the side of the subchondral bone and on the articular surface; and vascular invasion was observed. In the deep zone of the cartilage, there were hypertrophic chondrocytes with signs of chondroptosis, what indicated a violation of the chondrohematic barrier. Disorders of the basophilic line and penetration of the bone marrow pannus were revealed. From the side of the articular surface, a synovial pannus was observed invading the cartilage matrix. In chronic osteomyelitis of the phalanges and metatarsal bones, regardless of the phase of the inflammatory process, in all observations, disorders in the structure of the subchondral bone plate and articular cartilage were detected; there was invasion of blood vessels from the subchondral zone and articular surface that might be explained by the small size of those bones. Conclusion The intensity of articular cartilage destruction in chronic osteomyelitis of the calcaneus and talus depended on the location of the osteomyelitis focus and the phase of the inflammatory process. In chronic osteomyelitis of the phalanges and metatarsal bones, regardless of the phase of the inflammatory process, there were disorders in the structure of the articular cartilage and vascular invasion. The findings on structural changes in the articular cartilage in chronic osteomyelitis of adjacent bones are helpful for defining the tactics of surgical treatment.

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“…The "golden" standard is the histological method, which is one of the five special methods for the diagnosis of osteomyelitis [6].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Structural reorganization of the cartilage tissue in chronic osteomyelitis of the foot bones

Ступина¹,

Migalkin²,

Sudnitsyn³

2019

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“…In this study, the consensus criteria outlined by Berendt et al were used as the reference standard when the gold standard was not available. In clinical practice, physicians most often use the sum of clinical, laboratory and imaging results to diagnose OM . The sum of these results can be applied in an academic setting as a reference standard and have been used in all of the studies reviewed when the gold standard reference tool was absent .…”

Section: Discussionmentioning

confidence: 99%

Diagnosing osteomyelitis in the diabetic foot: a pilot study to examine the sensitivity and specificity of Tc^99mwhite blood cell‐labelled single photon emission computed tomography/computed tomography

Przybylski

Holloway

Vyce

et al. 2014

International Wound Journal

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Diabetic foot ulceration poses a significant threat of osteomyelitis (OM) and subsequent amputation. The diagnosis of OM via imaging studies is difficult as radiographic findings do not present immediately and advanced imaging studies may be contraindicated or unavailable. A novel diagnostic tool has been developed which synthesises technetium-99 white blood cell-labelled single-photon emission computed tomography and computed tomography (Tc(99m) WBC labelled-SPECT/CT) imaging, effectively enhancing anatomic detail. The aim of this pilot study was to determine the validity and reliability of this novel imaging technique in patients with diabetic foot ulcers in a Veterans Affairs healthcare facility. A retrospective review was performed on consecutive patients who met the inclusion criteria (n = 14) and underwent Tc(99m) WBC-labelled SPECT/CT for suspected OM. Histopathologic analysis of bone specimen (when available) and International Working Group on the Diabetic Foot consensus criteria were used as a reference standard. The sensitivity and specificity of Tc(99m) WBC-labelled SPECT/CT were 87·50% [confidence interval (CI): 64·58-110·42%] and 71·43% (CI: 37·96-104·90%), respectively. Negative predictive value (NPV) and positive predictive value (PPV) were 83·33% (CI: 53·51-113·15%) and 77·78% (CI: 50·62-104·94%), respectively, with a likelihood ratio (LR) of 3·063 and an accuracy of 80%. These findings suggest Tc(99m) WBC-labelled SPECT/CT can be useful in imaging OM in patients with diabetic foot ulcers.

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“…Acute periprosthetic joint infections usually result in the typical signs of inflammation: pain, swelling, reddening, and overheating of the affected joint, accompanied by fever. Postoperatively, impaired wound healing or secretion from the surgical wound, for example, may persist (30).…”

Section: Symptoms and Clinical Presentationmentioning

confidence: 99%

“…These typical signs of inflammation may be entirely absent in delayed or chronic infections, which are often caused by less virulent bacteria (low-grade infection). In these cases, the main symptoms include chronically persistent pain in the artificial joint, sometimes with implant loosening, and secondary implant failure (30).…”

Section: Symptoms and Clinical Presentationmentioning

confidence: 99%

Periprosthetic Infection in Joint Replacement

Otto-Lambertz¹,

Yagdiran²,

Wallscheid³

et al. 2017

Deutsches Ärzteblatt International

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The risk of infection of an artificial joint is low, but the overall prevalence of such infections is significant, as the number of implanted joints is steadily rising. Artificial joint infections should be treated by a standardized algorithm oriented toward the recommendations of current guidelines. Many of these recommendations, however, are based only on expert opinion, as informative studies providing high-grade evidence are lacking. Thus, for any particular clinical situation, there may now be multiple therapeutic approaches with apparently comparable efficacy. Randomized trials are urgently needed.

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Zur Definition der Diagnose Osteomyelitis – Osteomyelitis-Diagnose-Score (ODS)

Abstract: The osteomyelitis diagnosis score should help to avoid the false description of a clinical presentation as "osteomyelitis". A safe diagnosis is essential for the aetiology, treatment and outcome studies of osteomyelitis.

Cited by 36 publications

References 43 publications

Structural reorganization of the cartilage tissue in chronic osteomyelitis of the foot bones

Structural reorganization of the cartilage tissue in chronic osteomyelitis of the foot bones

Diagnosing osteomyelitis in the diabetic foot: a pilot study to examine the sensitivity and specificity of Tc^99mwhite blood cell‐labelled single photon emission computed tomography/computed tomography

Periprosthetic Infection in Joint Replacement

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Zur Definition der Diagnose Osteomyelitis – Osteomyelitis-Diagnose-Score (ODS)

Abstract: The osteomyelitis diagnosis score should help to avoid the false description of a clinical presentation as "osteomyelitis". A safe diagnosis is essential for the aetiology, treatment and outcome studies of osteomyelitis.

Cited by 36 publications

References 43 publications

Structural reorganization of the cartilage tissue in chronic osteomyelitis of the foot bones

Structural reorganization of the cartilage tissue in chronic osteomyelitis of the foot bones

Diagnosing osteomyelitis in the diabetic foot: a pilot study to examine the sensitivity and specificity of Tc99mwhite blood cell‐labelled single photon emission computed tomography/computed tomography

Periprosthetic Infection in Joint Replacement

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Product

Resources

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Diagnosing osteomyelitis in the diabetic foot: a pilot study to examine the sensitivity and specificity of Tc^99mwhite blood cell‐labelled single photon emission computed tomography/computed tomography