Possibilities with differential diagnosis of hematogenous osteomyelitis and malignant bone tumour

Tkachenko A.N., Noor O.F., Gaykovaya L.B., Korneenkov A.A., Kushnirchuk I.I., Ermakov A.I., Cherkasov A.Y.

Abstract


Introduction
Hematogenous osteomyelitis and malignant bone tumours are not rare and present a clinical and radiological variety of bone changes. Morphological patterns can be studied at large institutions having relevant medical facilities for the diagnosis of bone lesions. Despite the advanced technologies of recent decades used to verify the pathological conditions differential diagnosis of infectious diseases and malignant bone tumors is still a problem for medical science and practice.
Material and methods
The study included 96 patients with hematogenous osteomyelitis and 31 patients with malignant bone tumour characterised by atypical clinical manifestations that required differential diagnosis. A.Wald’s consecutive analysis was used to compare the findings of clinical, laboratory and instrumental examinations.
Results
Mathematical model for differential diagnosis of hematogenous osteomyelitis and malignant bone tumour was developed with database of 127 patients. 13 differential diagnostic criteria were identified and quantified including patients’ gender, age, comorbidities, localisation of the pathological process, results of laboratory tests, etc. An algorithm for differential diagnosis of hematogenous osteomyelitis and malignant bone tumour was devised. Immune parameters in blood of 63 patients were evaluated with prognostic purposes.
Conclusion
Practical evaluation of differential diagnosis of hematogenous osteomyelitis and malignant bone tumour showed accuracy of primary diagnosis of 89.2 % at outpatient phase and 91.6 % in the retrospective group that resulted in a reduced workup procedure and referral to a tertiary hospital.

Keywords


hematogenous osteomyelitis, malignant bone tumor, differential diagnosis

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