Medical Malpractice Insurance for orthopaedic surgeons

Laboratory and Radiographic Workup for Osteomyelitis

– Labs:     – WBC, ESR, CRP;     – gram stain and culture:          – prior to giving antibiotics, it is essential that a gram stain and culture be collected;                 – in hematogenous osteomyelitis, a bone aspirate is required which can usually … Read more

HypoPhosphatemia: diff dx

– Discussion: – normal phosphate serum levels are 3 to 4.5 mg/dL in adults and 4 to 7.5 mg/dL in children (Boyd & Olin, 1984); – hypophosphatemia occurs with serum P levels of < 0.8 mmol/L (2.5 mg/dL);- Differential Dx: – rickets / osteomalacia: – hypophosphatemia is the most common metabolic anomaly in rickets; – hypophosphatemic … Read more

Coagulation Labs

Coagulation Labs – Labs: PT/PTT/BT Thrombin Time FDP/Fibrinogen – See: – Bld Prod Menu – Fresh Frozen Plasma – Platlets – Coag Pathway – Hypercoagulable states – Vit K – DDAVP

Anemia w/u Labs

– Folic Acid / B12 deficiency – Iron: – Males 65-175 ug/dL; Females 50-170 ug/dL          – increased: – hemochromatosis, hemosiderosis caused by excessive iron intake, excess destruction or decreased production of erythrocytes, liver necrosis;          – decreased: – Anemia of Infection and Chronic dz, Cirrhosis, Nephrosis,  – Iron Binding Capacity (total) TIBC: – 250-450 ug/dL;          – normal … Read more

Alkaline Phosphatase

– Normal Values: Adult: 45-125 U/L, Child 20-150 U/L; – Increased: – increased calcium deposition in bone – hyperparathryroidism – pagets disease – osteomalacia / rickets: in both cases there is failure of mineralization; – caffey’s syndrome (infantile cortical hyperostosis) – osteoblastic bone tumors (metastatic or osteogenic sarcoma) – alk phos level is high in … Read more

ACID PHOSPHATASE

Radioimmunoassay (RIA) determination usually specific for prostate; not a screening test; Increased: Carcinoma of the prostate (usually metastatic), prostatic surgery or trauma; Rarely increased w/ infiltrative bone dz (Gaucher’s dz, myeloid leukemia), prostatitis, or benign prostatic hypertrophy;