BONE AND JOINT INFECTION OR INFLAMTION BONE INFECTION JOINT INFECTION GOUT/PSEUDOGOU AND RHEUMATOID ARTHRITIS Masalah infeksi sebagai pembelajaran mahasiswa seperti pada slide………… OSTEMYELITIS ACUTE OSTEMYELITIS CHRONIC ARTHRITIS ACUTE/ACUTE SEPTIC ARTHRITIS CHRONIC ARTHRTITIS

Radograph Examination Laboratory examination Joint Pain Problem Radograph Examination Laboratory examination Joint Infec- tion Arthritis Rheuma toid Arthtritis Gout/ Pseudogout Osteo-arthrosis Bone infection Armis - 2006

JOINT INFLAMATION SIGNS ERITHEMA, WARM AND PAIN, AND OEDEMA (SWELLING) INTRA-ARTICULAR FLUID (INFECTION AND INFLAMMATION) BONE OR JOINT RADIOGRAPHS AND LABORATORY DATA

REFERING INDICATION Kondisi Alasan untuk dirujuk Gagal melakukan aspirasi atau Artrosentesis sendi seperti sendi panggul atau sendi sakroiliaka Membutuhkan pedomen alat Tomografi Komputer atau Ultrasound Artritis Septik Konsultasi segera ke Ortopedi di Rumah Sakit, Antibiotik, Drainase sendi, Debridemen, konsultasi penyakit infeksi guna menentukan tipe infeksi Suspek Poliartritis Inflamatorik atau Unresponsive Monoartritis rekuren untuk dilakukan pengobatan Penilaian ahli Rematologis dan pengobatannya atau ke Ortopedis bila ada kelainan kartilago sendi atau alignment sendi Monoartritis Kronis yang tidak terdiagnosis Memerlukan biopsi sinovial secara tertutup oleh oleh ahli ortopedis atau melakukan artroskopi

CHRONIC ARTHRITIS ETILOGY: Staphylococcus Aureus, Tuberkolosis, Syphylis, and Viral or fungi. In children; metaphyisis area and microorganism invasion to the joint. Mikroorganisme invasion to joint by hematogen, or direct penetration. DIAGNOSIS: Physical examination (look, feel, and move), and investigation.

Decompression & culture Arthritis chronic Antibiotic injection Dressing and if necessary immobilization Drainage REFER: Decompression & culture and Surgery: arthroskopy and debridement, arthrodesis, Armis 2010

CHRONIC OSTEOMYELITI ACUTE OSTEOMYELITIS: The Infection During 2 Weeks. SUBACUTE OSTEOMYELITIS: Months CHRONIC OSTEOMYELITIS: More a Months or Years

CHRONIC OSTEOMYELITI DIAGNOSIS:History Taking, Physical Examination, and investigation RISK FACTORS: Malnutrition, renal or liver dysfunction, smoking, immun defiency, chronic hypoxia, malignancy diseases, Diabetes Mellitus, and elderly patient or steroid consumption. LABORATORY: Lekosit Count, ESR (Erithrocyt Sedimentation Rate), CR-P, Aspiration Culture RADIOGRAPHS: Soft tissue swelling, lytic and Squester and involukrum

Osteomyelitis chronic Antibiotic injection Dressing and if necessary immobilization Drainage REFER: Debridement & Culture and Surgery: squesterektomi or OREF. Armis 2010