CASE REPORT SURGERY DEPARTMENT

Akbal Nur Karim, S. Ked

K1A1 12 021

Osteomyelitis at Right Genu

EMERGENCY ROOM
BAHTERAMAS GENERAL HOSPITAL
KENDARI
 IDENTITY

Name : Mr. R
Age : 45 years old
Sex : Male
Adress : Buburanda Street
Occupation : Fisherman
Admission : 22 december 2018
Doctor in charge : dr Tri Tuty,Sp.OT
 Anamnesis (17.20)
 Main complain : pain at right knee
 History Taking :
Suffered since 3 weeks ago before admitted to the hospital.

 Pain continuously, not radiated and increased with movement, decreased when sleep
 There was previous treatment:
- Right Knee Surgery 3 months
- IVFD and analgetic at Kolono Primary Health Care
 There was no history complain from childhood
 There was history of fever, and cough
 There was history of weight loss
 There was no history of trauma
 There was no history of postoperative control since 2 months ago.
 The other complain, there were wound, pus discharge, smelly and swelling at the
right knee.
 PHYSICAL EXAMINATION(17.30)

General Condition : Moderate illness

Composmentis (GCS 15 E4V5M6),
Underweight

Vital Sign
BP : 90/60 mmHg
HR : 76x/minutes, regular, strong
RR : 20x/minutes, regular, spontaneous,
thoracoabdominal type, symetris
T : 37,9◦C
VAS : 6/10
 PRESENT STATE

Head : Within Normal Limit

Ears : Within Normal Limit
Face : Within Normal Limit
Neck : Within Normal Limit
Eyes : Within Normal Limit
Chest : Within Normal Limit
Nose : Within Normal Limit
Upper Limb : Within Normal Limit
Mouth : Within Normal Limit
Lower Limb : Localized State
Localized state (Right lower limb)

Right Knee
 Inspection: Deformity (+), swelling (+), eritem (+),
wound (+)size 1,8 cm x 1,3 cm, pus (+)
 Palpation : tenderness (+), warm (+)
 ROM : active and passive movement knee joint
limited due to pain
 NVD : good sensibility, dorsalis pedis artery
pulsation (+), CRT < 2 second.
CLINICAL FINDING
 PLANNING

Routine blood test

Blood chemistry test
Pus culture
Plain photo Right Knee Joint AP/Lat
 LABORATORY FINDING
ROUTINE BLOOD TEST
December 22 th 2018
PARAMETER RESULT

WBC 6.10 /Ul

RBC 4.47 /uL

HB 12 g/dL

PLT 116 x /uL

BLOOD CHEMISTRY TEST

December 22 th 2018

PARAMETER RESULT

Blood Glucose 73 mg/dl

RADIOLOGI FINDING
 DIAGNOSIS

Chronic Osteomyelitis at Right Knee

Differential Diagnosis :
- Septic arthritis at Right knee
- Osteomyelitis tuberkulosa at Right Knee
- Primary bone tumor at right knee
- Abses at right Knee
 MANAGEMENT
Pharmacological Non-Pharmacological
• IVFD
 Wound care
• Antibiotic injection
• Analgetic injection  Rest

• Antipiretic injection  Immobilization

• H2R Antagonist injection  Elevation

 Education

Consult to orthopaedic surgeon

Thank You