Acute Osteomyelitis

Question 1

Infection of the bone

Answer 1

Osteomyelitis

Question 2

Osteomyelitis pathophysiology

Answer 2

direct inoculation

hematogenous dissemination (rare in adults, common in peds)

Question 3

Osteomyelitis risk factors

Answer 3

Peripheral vascular disease

diabetes

recent orthopedic surgery

Question 4

Osteomyelitis presentation

Answer 4

overlying erythema

edema

tenderness

fever, chills, fatigue

Question 5

Osteomyelitis differential

Answer 5

cellulitis

necrotizing fasciitis

Question 6

Osteomyelitis diagnosis

Answer 6

Blood cultures

CBC, ESR/CRP

XR (may normal in first 10-14 days), (periosteal elevation on XR)

If XR is normal then MRI

If MRI is normal then bone biopsy

Question 7

Osteomyelitis treatment

Answer 7

Broad coverage Abx

Narrow with cultures

4-6 weeks of Abx oral or IV

Question 8

Osteomyelitis pathogens

Answer 8

S aureus

Salmonella if sickle disease present

Pseudomonas in setting of IV drug use or diabetes