BIOC33H3 Lecture Notes - Humerus, Osteomyelitis, Epiphyseal Plate
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Chapter 64: Musculoskeletal Problems
Osteomyelitis is a severe infection of bone, bone marrow, and surrounding soft tissue.
Infecting microorganisms can invade by indirect or direct entry. After entering the blood, they
lodge in an area of bone and grow which results in increased pressure, eventually leading to
Once ischemia occurs, the bone dies.
Chronic osteomyelitis is a continuous, persistent problem or a process of exacerbations and
Acute symptoms are fever, night sweats, malaise, and constant bone pain.
Some immobilization of affected limb (e.g., splint, traction) is indicated to decrease pain. The
patient is frequently on bed rest in the early stages of the acute infection.
Vigorous and prolonged IV antibiotic therapy is treatment of choice for acute osteomyelitis.
Oral antibiotics, hyperbaric oxygen therapy, and surgery may be prescribed for chronic disease.
Most primary bone cancer is called sarcoma.
Sarcomas can also develop in cartilage, muscle fibers, fatty tissue, and nerve tissue.
Common types are osteogenic sarcoma, chondrosarcoma, Ewing’s sarcoma, and chordoma.
Osteochondroma is a primary benign bone tumor characterized by overgrowth of cartilage and
bone near end of the bone at the growth plate.
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Manifestations include painless, hard, and immobile mass, one leg or arm longer than other,
and pressure or irritation with exercise.
No treatment necessary if asymptomatic. If patient has pain or neurologic symptoms due to
compression, surgical resection is usually done.
Nursing care does not differ significantly from the care given to patients with a malignant
disease of any other body system.
Osteogenic sarcoma (osteosarcoma) is a primary bone tumor that is extremely aggressive and
rapidly metastasizes to distant sites.
Manifestations are usually associated with gradual onset of pain and swelling, especially around
Preoperative (neoadjuvant) chemotherapy is used to decrease tumor size.
Limb-salvage procedures are considered when there is a clear 6- to 7-cm margin surrounding
Metastatic Bone Cancer
The most common type of malignant bone tumor occurs as a result of metastasis from a primary
Metastatic bone lesion is commonly found in vertebrae, pelvis, femur, humerus, or ribs.
Metastasis to bone may be suspected in patients with local bone pain and past cancer history.
Treatment may be palliative and consists of radiation and pain management.
LOW BACK PAIN
Low back pain is common, affecting about 80% of adults during their lifetime.
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