Acute Osteomyelitis Flashcards
What is osteomyelitis?
Infection of bone, including osteoid and myeloid components
Osteomyelitis is characterized by inflammation caused by infecting organisms.
What are the signs of inflammation in osteomyelitis?
Redness, swelling, heat, pain, loss of function
These signs may be limited or affect multiple portions of the bone.
What is the key to successful management of osteomyelitis?
Early diagnosis and aggressive antimicrobial and surgical treatment
A multidisciplinary approach is also required.
What are local risk factors for osteomyelitis?
- Trauma
- Diminished sensibility
- Peripheral vascular diseases
- Foreign bodies
- Septic foci
Examples of septic foci include boils and sore throat.
What are systemic risk factors for osteomyelitis?
- Age
- Malnutrition
- Chronic illness
- Steroids
- Immune deficiencies
- Iatrogenic invasive measures
Chronic illnesses include diabetes mellitus and sickle cell disease.
What are the mechanisms of infection in osteomyelitis?
- Direct inoculation
- Contiguous spread
- Haematogenous spread
Haematogenous spread is the most common route in children.
Which organism is the most common cause of osteomyelitis?
Staphylococcus aureus (over 70%)
Other organisms include Streptococcus pyogenes and Streptococcus pneumoniae.
What is the bimodal distribution of osteomyelitis in children?
Common in children under 2 years and between 8-12 years
More than half of affected children are less than 5 years old.
What is the typical pathology progression in osteomyelitis?
- Inflammation
- Suppuration
- Necrosis
- New bone formation
- Resolution and healing
The pathology can vary based on age, site of infection, virulence, and host response.
What occurs during the suppuration stage of osteomyelitis?
Pus forms within 2-3 days, potentially causing subperiosteal abscess
Pus can spread along the diaphysis and may burst into surrounding soft tissues.
What are the common diagnostic investigations for osteomyelitis?
- Plain radiograph
- Ultrasound
- MRI
- Blood culture
Blood cultures are positive in about 50% of cases.
What are the principles of treatment for osteomyelitis?
- Appropriate antimicrobial therapy
- Surgical drainage if required
- Supportive treatment
The initial therapy is often empirical, followed by specific treatment.
Fill in the blank: The mainstay of treatment for osteomyelitis is _______.
[Antibiotics]
What are the indications for surgical treatment of osteomyelitis?
- Presence of an abscess requiring drainage
- Failure to improve despite appropriate intravenous antibiotic treatment
Procedures may include drainage of subperiosteal abscess and cortical windowing.
What are common complications of osteomyelitis?
- Epiphyseal/physeal damage
- Septic arthritis
- Metastatic infection
- Pathological fracture
These complications can arise if the infection is not managed effectively.
True or False: Prognosis for osteomyelitis is poor if early diagnosis and treatment are provided.
False
Prognosis is usually excellent with early diagnosis and prompt appropriate treatment.
What is the role of a multidisciplinary approach in treating osteomyelitis?
It is required for effective management of the condition
Collaboration among various healthcare professionals enhances treatment outcomes.
