What is a Brodie abscess: causes, symptoms, diagnosis and treatment
Bone Brodie abscess, as a complex variety of osteomyelitis
A large number of diseases affected the human body. The disease can damage internal organs, skin and bones.
This disease, which causes enormous troubles for people, is a Brodie abscess. It is found quite rarely, but to know about it.
What it is
Disease of Brodie abscess is one of the forms of hematogenous osteomyelitis. The inflammation is localized in epimetaphyseal part of the long tubular bones. Most often, it is the tibial epiphysis and the distal epiphysis of the radius.
The disease is most common in adolescents and males.
The causative agent of the inflammation – a strain of staph. Pockets of damage single. Their size and form depend on the duration of the disease:
- At an early stage they are oblong like a drop. Reach a size from one half to two centimeters.
- For long term illness, their shape becomes spherical, the diameter is five inches.
Clinical feature of Brodie abscess is of long duration. The process may continue for several decades.
The causes of the disease
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Focal bacterial infection. Most often, staphylococcal. The body weakens, immunity decreases. He can no longer fight against diseases and they begin to «attack». Usually, Brodie abscess is preceded by osteomyelitis.
Ways of penetration of microorganisms into the body:
- damage to the skin;
- the accumulation of a large amount of blood;
- purulent infection.
Getting chemical substances under the skin when:
- the introduction of highly concentrated medicinal substances;
- subcutaneous injections and IVS.
It should be added that the penetration can occur only in the case if you do not observe aseptic rules. There were cases when twenty years after the onset of the disease, purulent discharge was detected virulent bacteria.
The clinical picture
Symptoms can be different. The first thing you should notice is that when pressing on the hearth, there is limited sensitivity.
At night, when a strong physical exertion manifested pain.
The first sign of the disease is:
- the presence of a binding site;
- swelling and redness around it.
In the future, after a few days, or even weeks, there is a capsule filled with pus.
The disease may years to disturb the man, giving him a small respite.
Aggravation occurs accompanied sometimes:
- an increase in temperature;
- redness around the inflamed area;
- pain when pressure is applied.
Visual examination of the expert does not give a complete picture of the disease.
Diagnosis in a medical institution
Consists of two stages.
Brodie abscess is diagnosed by x-ray. This method is crucial in the definition of the disease and the treatment.
The images obtained during the procedure, the specialist sees that in the spongy part of the tibia appeared cavity. Its diameter is from two to two and a half inches and it is surrounded by area of sclerosis.
Itself cavity filled with pus, serous or bloody fluid. A closer view can be seen in it the detritus of tissue.
The differential diagnosis
It is needed in order to exclude or confirm the presence of diseases such as:
- osteoid osteoma;
- tuberculous osteitis;
- eosinophilic granuloma.
Most believe that the disease is articular. Only using differential screening, it is possible to refute this view. On radiographs it is evident that the covered by inflammation of the metaphyseal part of the bone.
After two stages of diagnosing, obtaining the results desired, it is possible to ascertain that the patient is likely to Brodie abscess.
At the initial stage of the disease conservative method is used:
- With the limb in a plaster for three to four weeks. Thus, the damaged area is fixed.
- Intramuscular antibiotics are.
- During exacerbation of the disease, is anti-inflammatory radiotherapy, occasionally scraping of the lesion and the introduction into its cavity of penicillin.
- Physiotherapy, often UHF.
- A restorative treatment.
- High-calorie food.
In the case that the conservative method does not bring positive results, applies the second method is surgery.
Completely removed the damaged part of the bone. After a while it is replaced with a graft.
During surgery, a craniotomy is made of the cavity, the inner wall vystavlyaetsya, the wound is sutured.
Sometimes on their own. This process is very painful, pus breaks through into the soft tissue, a fistula.
Based on the foregoing, we can conclude: Brodie abscess is a very dangerous bone disease. Susceptible teenagers and young people under the age of twenty-five years, most often male.
In the early development of disease symptoms.
Clinical feature – long duration. Often it has been delayed for three decades. The correct diagnosis can only be made in an x-ray. There are two methods of treatment that can be used in complex conservative and surgical intervention.