[33] Acute Osteomyelitis Flashcards
Is the source of acute osteomyelitis local of haematogenous?
Can be either
What organisms can cause acute osteomyelitis?
Staph Strep E. coli Pseudomonas Salmonella
What are the risk factors for acute osteomyelitis?
Vascular disease Trauma Sickle cell anaemia Immunosuppression, e.g. DM Children
Why are children at increased risk of acute osteomyelitis?
Rich blood supply to growth plates
Where does acute osteomyelitis usually affect in children?
Metaphysis
What are the symptoms of acute osteomyelitis?
Pain and tenderness
Signs of systemic infection
What may be found on examination in acute osteomyelitis?
Erythema and warmth
Reduced range of movement
Effusion in neighbouring joints
What investigations may be done in acute osteomyelitis?
Bloods
X-ray
MRI
What changes might be seen on bloods in acute osteomyelitis?
Increased ESR/CRP
Increased WCC
What % of cases of acute osteomyelitis can positive blood cultures?
60%
How long do x-ray changes take to occur in acute osteomyelitis?
10-14 days
What may be seen on x-ray in acute osteomyelitis?
Haziness with decreased bone density
Sub-periosteal reaction
Sequestrum and involucrum
What is good about MRI in acute osteomyelitis?
It is sensitive and specific
How is acute osteomyelitis managed?
Antibiotics
Drain abscess and remove sequestra
Analgesia
What antibiotics are used in acute osteomyelitis?
Vancomycin and cefotaxime
