Urgency. Although the basic pathomorphologic features of bone lesion in destructive form of osteomyelitis with latent clinical course (Brodie’s abscess) are known from the literature, the thorough analytical clinical-morphologic studies have not been yet conducted.Purpose of study: Based on the results of the study to establish correlation dependence between clinical, clinical-laboratory indices and morphologic foci parameters.Material and methods. Fragments of pathologic foci tissues from 25 patients with Brodie’s abscess (31 samples) were the study material. The results of clinical, visualizing and clinical-laboratory methods as well as morphometric semi-quantitative indices characterizing the state of foci tissues were used for the gradationfrequency and correlation analysis.Results. In Brodie’s abscess the bone tissue morphologic changes are presented by spongiosa necrosis and resorption. More often the cases with granulation tissue within the internal capsule of a membrane prevailed. The evidence of exudative inflammation corresponded to the low degree of activity, of a productive one — to high activity. In the majority of cases small sequesters within the capsule tissues were detected. Reliable (p<0.05) correlations that corresponded to absolute values of correlation coefficient ra in the range of 0.3 — 0.7 were determined for the following indices: “patient’s age” — “exudative inflammation within the capsule”, “white blood cells” — “pattern of capsule connective tissue”, “white blood cells” — “productive inflammation within the capsule”, “white blood cells” — “presence of sequesters”, “Antistaphylococcal antibodies” — “exudative inflammation within the capsule”.Conclusion. Determined clinical-morphologic correlations could be used to improve both clinical and morphological diagnosis of bone inflammatory lesions.
Background. Knowledge about the pathological processes in the tissues of the limb is necessary for the targeted optimization of their course, the expectation of certain treatment results. The aim of the study was to determine the ratio of different severity cases and the correlation between individual clinical, laboratory and morphometric indicators of the tissues state in patients with trophic disorders in the extremity.Materials and Methods.The material was fragments of the lower leg tissues (bones, soft tissues, skin) of 38 patients with chronic post-traumatic osteomyelitis. Gradation morphometric indicators reflecting the tissues state in the lesion focuses were used. Frequency analysis of semiquantitative indicators and correlation analysis of the relationships between clinical, laboratory and morphometric indicators with the evaluation of the association coefficient were carried out. Results.Trophic disorders in the limb tissues (bones, soft tissues, muscles, skin), observed in patients with lower leg bones post-traumatic osteomyelitis, do not represent a group of well-defined pathological processes. They form a complex of dyscirculatory, ischemic, necrotic, dystrophic, atrophic, inflammatory, reparative and regenerative changes, which are combined in tissues in different proportions. This involves the use of a number of quantitative and semi-quantitative, gradation indicators: clinical, laboratory, and pathomorphological. Pathomorphological changes in the lesions in patients with chronic posttraumatic osteomyelitis of the lower leg bones with clinical signs of trophic disorders do not differ qualitatively from the changes usually detected in chronic post-traumatic osteomyelitis. In the bones, the most frequent are destructive focuses with a predominance of exudative and productive inflammation of high activity, sequestration and osteonecrosis. In paraossal soft tissues, more common are focuses, in which mature fibrous tissue and productive inflammation of low activity predominate. In the skin near the chronic post-traumatic osteomyelitis focuses, there is dermis fibrosis and productive inflammation of low activity.Conclusion. A number of correlations between clinical and laboratory parameters, on the one hand, and morphological parameters, on the other, have been established. The closest and most stable connections for different sites are the following indicators: blood leukocytes (negative dependence for affected bone, soft tissue and skin tissues), ESR (positive dependence for soft tissues), C-reactive protein (positive dependence for soft tissues and skin), agglutination with a polyvalent strain of Staphylococcus aureus (negative dependence for affected bones and skin).
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