Osteomyelitis of the ribs in Ibadan.

Abstract

Sixteen patients with pyogenic osteomyelitis of the ribs are reported; ages ranged from 3 months to 42 years and 10 were female. Right sided ribs were affected in 10 cases and single ribs in 12. Antecedent causes included empyema thoracis (56%) and blunt chest trauma (19%). Fourteen out of 16 patients presented with discharging chest wall sinuses and five patients had associated swellings on the chest wall. The duration of symptoms ranged from two to 36 months. The most common microorganism isolated was Staphylococcus aureus (50%). Rib excision (with drainage of the empyema in two cases) was curative in all 16 cases in this study.Osteomyelitis of the ribs appears to be a rare disease in both the tropical and the temperate areas of the world.13 Adeyokunnu and Hendrickse,4 in a review of 63 cases of salmonella osteomyelitis seen in Nigerian children, found no case of rib osteomyelitis. Similarly, Dich et al1 reviewed 163 cases of osteomyelitis in infants and children over 15 years and found only one case (0.6%) affecting the ribs.Osteomyelitis of the ribs has been found in association with childhood empyema, -7 Staphylococcus aureus infection,1 sickle cell anaemia, and infection due to Salmonella and Klebsiella species and Proteus rettgeri.3 Osteomyelitis arising in ribs adjacent to sites of intubation in the chest in children with empyema has been documented by Osinowo et al.7 The present report reviews 16 cases of rib osteomyelitis treated by our cardiothoracic unit over seven and a half years. From this experience and a review of the published reports we consider the aetiology, pathogenesis, clinical presentation, and results of treatment of the disease. MethodsThe records of all patients with rib osteomyelitis admitted to the unit from January 1975 to May 1983 formed the basis of this prospective study.The data extracted from each patient's record included the age, sex, clinical presentation, radiological findings, mode and results of treatment, and the results of bacteriological and routine haeAddress for reprint requests: Dr 0 Osinowo,

Imaging of Chest Wall Disorders

“…The most common causative organisms in pyogenic infection are Staphylococcus aureus and Pseudomonas aeruginosa (13). Pyogenic osteomyelitis of the ribs and sternum is generally associated with an adjacent soft-tissue mass, loss of deep soft-tissue planes, and periosteal elevation.…”

Osteomyelitis of The Rib: A Case Report

“…The patients generally present with fever, pain and an abscess or sinus that fails to heal (Marta Nascimento, et al, 2012;Osinowo, et al, 1982). The most common infecting pathogen is Staphylococcus aureus.…”

“…The diagnosis of rib osteomyelitis is relatively fast and accurate with the advent of CT and MRI. The definitive diagnosis of rib osteomyelitis requires culture of the aspirated pus, blood culture or bone biopsy (Kaplan SL;1982;Conrad DA., et al, 2008). Treatment is usually with intravenous antibiotic or antitubercular therapy depending on the organism grown.…”

“…Osteomyelitis of the rib is associated with childhood empyema., sickle cell anaemia and infection primarily due to staphylococcus aureus, Mycobacterium tuberculosis and Klebsiella species. Osteomyelitis of the rib are known to occur adjacent to the site of insertion of the intercostal drainage tubes in children with empyema (Osinowo, et al, 1982).We report a rare case of pyogenic osteomyelitis involving the right 6 th rib.…”

Acute osteomyelitis of the rib in a neonate

“…Vancomycin administered intravenously is the gold standard for treating osteomyelitis due to MRSA infection 5 . Resection of the rib offers the best treatment for pyogenic rib osteomyelitis 6 .…”