Osteomyelitis: Difference between revisions
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==Gross processing== | ==Gross processing== | ||
*Measure the specimen | *'''Measure''' the specimen. | ||
* | *'''Bisect''' clinically or visibly suspected areas, in longitudinal direction when possible. | ||
* | *'''Fix''' the specimen in formalin. | ||
*Potentially sample as a standard [[amputation]] | *'''Decalcify''' the specimen. | ||
*'''Sample''' from: | |||
:*Visibly '''affected''' areas | |||
:*Proximal surgical bony '''margin''', if present, [[inked]] and as a longitudinal section. | |||
*Potentially sample as a standard '''[[amputation]]''', such as for '''[[toe]]'''. | |||
==Microscopic evaluation== | ==Microscopic evaluation== | ||
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===Further workup=== | ===Further workup=== | ||
[[File:Mark made at significant osteomyelitis inflammation.jpg|thumb|Green mark made at significant osteomyelitis inflammation.]] | [[File:Mark made at significant osteomyelitis inflammation.jpg|thumb|Green mark made at significant osteomyelitis inflammation, by multiple neutrophils.]] | ||
For '''[[toe]]''' amputations, determine its extent, particularly compared to the bony surgical or articular margin. Start at the margin and scan the bone at at least intermediate magnification until significant inflammation is seen. Preferably make a mark there and measure the distance from the mark to the margin. | For '''[[toe]]''' amputations, determine its extent, particularly compared to the bony surgical or articular margin. Start at the margin and scan the bone at at least intermediate magnification until significant inflammation is seen. Preferably make a mark there and measure the distance from the mark to the margin. | ||
Latest revision as of 10:35, 6 March 2025
Author:
Mikael Häggström [note 1]
Gross processing
- Measure the specimen.
- Bisect clinically or visibly suspected areas, in longitudinal direction when possible.
- Fix the specimen in formalin.
- Decalcify the specimen.
- Sample from:
- Visibly affected areas
- Proximal surgical bony margin, if present, inked and as a longitudinal section.
- Potentially sample as a standard amputation, such as for toe.
Microscopic evaluation
The main sign of acute osteomyelitis is the presence of numerous neutrophils in the stroma. It may also have lymphocytes, plasma cells, bone necrosis,' capillary proliferation and fibrosis.[1]
-
Acute osteomyelitis: Numerous neutrophils in the stroma.
Further workup
For toe amputations, determine its extent, particularly compared to the bony surgical or articular margin. Start at the margin and scan the bone at at least intermediate magnification until significant inflammation is seen. Preferably make a mark there and measure the distance from the mark to the margin.
Microscopic report
Example:
| (A. Left third toe, amputation:) Toe with ulcer and osteomyelitis. Osteomyelitis involves the distal phalanx, middle phalanx and proximal phalanx. Osteomyelitis is 2.0 cm from the proximal articular surface of the proximal phalanx. |
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Dariusz Borys. Bone & joints - Osteomyelitis - Bacterial osteomyelitis (acute). PathologyOutlines. Topic Completed: 1 June 2012. Minor changes: 28 June 2019
Image sources