Difference between revisions of "Bones Inflammatory - Pathology"

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===Bone infections in general===
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#REDIRECT[[:Category:Bones - Inflammatory Pathology]]
 
*'''Caused by''':
 
**Bacteria most commonly (e.g. [[Mandibular Osteomyelitis|lumpy jaw]] in cattle due to ''[[Actinomyces bovis]]'')
 
**Viruses, fungi and protozoa less commonly
 
 
 
*'''Routes of infection''':
 
**“Inoculated” at time of [[Bones Fractures - Pathology|fracture]]
 
**Extension from other infected sites ([[Sinusitis|sinuses]], middle ear, [[Joints Inflammatory - Pathology|joints]])
 
**Haematogenous (young farm animals)
 
 
 
*'''Gross lesions'''
 
**Suppurative exudate (in bacterial infection), necrosis, bone proliferation, pathological fractures
 
**Dead bone portions may be separated from blood supply and form bone sequestra
 
 
 
*'''Consequences'''
 
**Extension to adjacent bone
 
**Haematogenous spread to other bones and soft tissue
 
**Pathologic fractures
 
**Sinus tracts to exterior
 
 
 
*'''Osteitis''' = inflammation of bone
 
*'''Periostitis''' = inflammation of periosteum, usually develops from infection in adjacent tissues
 
*'''Osteomyelitis''' = inflammation of medullary cavity
 
 
 
===Osteitis===
 
 
 
*E.g.: [[Fusobacterium necrophorum|''Fusobacterium necrophorum'']] in the foot, [[Respiratory Bacterial Infections - Pathology#Necrotic laryngitis|calf diphteria]], bite wounds, extension from paranasal sinuses, compound fractures, extensions from infections in the joints, [[Alveolar Periostitis|periodontal disease]], [[Respiratory Bacterial Infections - Pathology#Atrophic Rhinitis|Atrophic rhinitis]]
 
 
 
===Osteomyelitis===
 
[[Image:Cattle localised osteomyelitis with sequestrum.jpg|right|thumb|100px|<small><center>Localised osteomyelitis plus sequestrum (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
 
 
 
*Mainly due to haematogenous spread in young animals
 
*Often as an extension from [[Joints Inflammatory - Pathology#Arthritis|suppurative arthritis]]
 
*Usually isolated: ''[[Actinomyces pyogenes]]'', [[Salmonella|''Salmonella'']], [[Escherichia coli|''E.coli'']], [[Klebsiella|''Klebsiella'']], [[:Category:Streptococcus species|''Streptococci'']]
 
*Metaphyses and epiphyses mostly affected
 
*Most infections are exacerbated by host response
 
*Pathogenesis:
 
**Prostaglandin and cytokines stimulate [[Bones - normal#Normal structure|osteoclastic]] bone resorption
 
**Blood vessel occlusion and tissue necrosis -> lack of removal of agent and cartilage -> cartilage thickening + persistance of infection
 
*Affected area may be surrounded by fibrous inflammatory tissue
 
*Metaphyseal abscesses may develop
 
*Sequestra may also develop -> surrounded by [[Granulation Tissue|granulation tissue]]
 
**Isolated from osteoclastic resorption
 
**May persist for long time
 
**Obstruct repair
 
 
 
 
 
*'''Vertebral osteomyelitis'''
 
**Lesions may affect the spinal cord
 
**Usually due to ''[[Actinomyces pyogenes]]''
 
**Suppurative inflammation may cause fracture of vertebral body -> dorsal displacement -> damage to spinal cord
 
**May form encapsulated abscess protruding into spinal canal -> spinal cord compression
 
 
 
*'''''Actinomycosis'''''
 
**= '''Lumpy jaw''' in cattle
 
**Caused by ''[[Actinomyces bovis]]''
 
***Gram positive, branching, filamentous
 
***Obligatory parasite of mucous membranes of [[Oropharynx - Anatomy & Physiology|oropharynx]]
 
***Surface tissue is usually injured for infection to occur
 
***[[Mandibular Osteomyelitis|Osteomyelitis of mandible]] -> destruction of bone -> replacement by fibrous tissue with pyogranulomatous nodules cotaining 'club colonies' of bacteria
 
***Suppurative osteomyelitis
 
***Fistulous tracts may discharge onto skin and into [[Oral Cavity Overview - Anatomy & Physiology|oral cavity]]
 
***Excessive periosteal bone formation
 
***Greatly enlarged mandible
 
 
 
===Periostitis===
 
 
 
*Chronic periostitis - pockets of exudate and irregular new bone fomation
 
 
 
===Panosteitis===
 
[[Image:Panosteitis.jpg|right|thumb|100px|<small><center>Panosteitis (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
 
 
 
*Typically young large or giant breeds
 
*75% of cases in German shepherd dogs, 5-12 months old
 
*Clinical signs:
 
**Shifting lameness
 
**Often eosinophilia in peripheral blood
 
*Usually self-limiting in one to several months
 
*Grossly:
 
**Foreleg long bone '''diaphyses''' affected (multiple bones in 50% of cases)
 
**Increased bone formation in the medullary cavity and often in the periosteum
 
*Contast with [[Bones Hyperplastic and Neoplastic - Pathology#Hypertrophic osteodystrophy|'''hypertrophic osteodystrophy''']]
 
 
 
 
 
[[Category:Musculoskeletal System - Pathology]]
 

Latest revision as of 12:12, 3 March 2011