In those with a close relative diagnosed with an aortic aneurysm, Swedish guidelines recommend an ultrasound at around 60 years of age.Australia has no guideline on screening.Repeat ultrasounds should be carried out in those who have an aortic size greater than 3.0 cm. In those whose aorta is between 3.0 and 3.9 cm this should be every three years, if between 4.0 and 4.4 cm every two years, and if between 4.5 and 5.4 cm every year. Management
The treatment options for asymptomatic AAA are conservative management, surveillance with a view to eventual repair, and immediate repair. Two modes of repair are available for an AAA: open aneurysm repair, and endovascular aneurysm repair (EVAR). An intervention is often recommended if the aneurysm grows more than 1 cm per year or it is bigger than 5.5 cm. Repair is also indicated for symptomatic aneurysms. Ten years after open AAA repair, the overall survival rate was 59%. Mycotic abdominal aorta aneurysm (MAAA) is a rare and life-threatening condition. Because of its rarity, there is a lack of adequately powered studies and consensus on its treatment and follow up. A management protocol on the management of mycotic abdominal aortic aneurysm was recently published in the Annals of Vascular Surgery by Premnath et al. Conservative
Conservative management is indicated in people where repair carries a high risk of mortality and in patients where repair is unlikely to improve life expectancy.
Osteomyelitis (OM) is an infection of bone. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. The long bones of the arms and legs are most commonly involved in children e.g. the femur and humerus, while the feet, spine, and hips are most commonly involved in adults.The cause is usually a bacterial infection, but rarely can be a fungal infection. It may occur by spread from the blood or from surrounding tissue. Risks for developing osteomyelitis include diabetes, intravenous drug use, prior removal of the spleen, and trauma to the area. Diagnosis is typically suspected based on symptoms and basic laboratory tests as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).This is because plain radiographs are unremarkable in the first few days following acute infection. Diagnosis is further confirmed by blood tests, medical imaging, or bone biopsy.Treatment of bacterial osteomyelitis often involves both antimicrobials and surgery. In people with poor blood flow, amputation may be required. Treatment of the relatively rare fungal osteomyelitis as mycetoma infections entails the use of antifungal medications. In contrast to bacterial osteomyelitis, amputation or large bony resections is more common in neglected fungal osteomyelitis, namely mycetoma, where infections of the foot account for the majority of cases. Treatment outcomes of bacterial osteomyelitis are generally good when the condition has only been present a short time. About 2.4 per 100,000 people are affected each year. The young and old are more commonly affected. Males are more commonly affected than females.