20.1 Septic Arthritis& osteomyelitis Flashcards
septic arthritis, poor outcome in what %?
27%
40% if hip
most likely infective organism in osteomyelitis?
staph aureus
what age group highest in septic arthritis
<2
why more likely to get a metaphyseal infection in kids 3 main factors?
- vascular loops/terminal branches
- low p02, inhibits phagocytosis
- trauma
role of ultrasound?
- subperiosteal abscesses
- septic arthritis
bone scan: triple phase for osteomyelitis? when use?
- diagnostic in 84%
- difficult locations
- equivocal signs
indications for surgey in osteomyelitis?
-aspiration for culture
-abscess drainage
-joint sepsis
debridement
-biopsy in equivocal
where does subacute osteomyelitis happen?
- metaphyseal
- epiphyseal
subacute osteomyelitis diagnosis?
slow onset, generally well, usually treat with antibiotics
3 routes for septic arthritis?
- haematogenous
- Direct: from metaphyseal osteomyelitis
- direct inoculation
3 most common joint in kids for septic arthritis?
knee
hip
ankle
septic arthritis WCC raised greater than?
> 12000/mm3
ddx for septic arthritis?
- transient synovitis of hip
- reactive arthritis
septic arthritis prediction rules, the 4 classes?
Fever
non-weight bearing
ESR >40
WCC >12000
if all 4: 99.8% of septic arthritis
treatment of septic arthritis?
- ANTIBIOTICS
- aspiration
- arthroscopy (wash out)
- arthrotomy
