Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26504719
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 GMS+Interdiscip+Plast+Reconstr+Surg+DGPW
2014 ; 3
(ä): Doc08
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Histopathological Osteomyelitis Evaluation Score (HOES) - an innovative approach
to histopathological diagnostics and scoring of osteomyelitis
#MMPMID26504719
Tiemann A
; Hofmann GO
; Krukemeyer MG
; Krenn V
; Langwald S
GMS Interdiscip Plast Reconstr Surg DGPW
2014[]; 3
(ä): Doc08
PMID26504719
show ga
BACKGROUND: Treatment and diagnosis of osteomyelitis are still a challenging
problem for surgeons, microbiologists and histopathologists. A direct
microbiological detection of bacteria in tissues is still gold standard, but it
is not always successful for example in chronic osteomyelitis and/or when an
antibiotic treatment has already been started or in cases of low virulent
bacteria. The goal of this study was to define diagnostic criteria of
osteomyelitis, the inflammatory regression of osteomyelitis ("osteomyelitis
score") under specific therapy by the correlation of histopathological and
microbiological and clinical standard tests. METHODS: In this retrospective
analysis patients with medical history and clinically clear signs of bacterial
infection and osteomyelitis underwent surgery between 01.01.2013 and 31.12.2012.
Their formal consent was given. Tissue samples were taken during surgery
according to defined criteria including surgical interventions. Histopathological
diagnosis was carried out by conventional techniques based on defined criteria of
bacterial infection in connective tissue, peri-implant membrane and bone. These
results were carried out in tables by numbers representing the histopathological
criteria of acute osteomyelitis (A1 to A3) as well as the chronic criteria (C1
and C2) in a semiquantitative way (scale 0 to 3). On the other hand a notational,
graduated histopathological report was performed. Preoperative clinical
diagnosis, perioperative macroscopic diagnosis, histopathological and
microbiological findings were correlated. RESULTS: Histopathological samples of
52 surgical interventions based on the preoperative diagnosis "osteomyelitis"
(AOM, ECOM or COM) were included. 37 times preoperatively signs of a chronic
osteomyelitis (COM), 10 times preoperatively acute osteomyelitis (AOM) was
diagnosed. Another 5 patients were preoperatively diagnosed as acute exacerbated
osteomyelitis (ECOM). The correlation of the histopathological infection
including the inflammatory activity and microbiological detection of bacteria was
57%. The correlation between preoperative diagnosis and histopathological
findings was 68%. CONCLUSION: The relatively small 68% correlation between
clinical preoperative and histopathological diagnosis and 57% correlation between
preoperative clinical diagnosis and microbiological findings indicates: Clinical
findings are not sufficient for the diagnosis "osteomyelitis".Clinical findings
are not sufficient for the differentiation between AOM, ECOM and
COM.Histopathological analysis is the critical factor for the diagnosis
("osteomyelitis") and differential diagnosis (AOM vs. COM).Histopathological
analysis represents the basis for further treatment.HOES facilitates the
classification of the histopathological findings.HOES is a sufficient tool for
the treating physician in order to define the further treatment.