Bone and Joint Infection Flashcards
What are the 2 most useful blood tests for a suspected bone and joint infection
CRP
Plasma viscosity
Who is most likely to develop acute osteomyelitis
Post-traumatic/ open # = inoculation
Children or immunosuppressed = haematogenous
What is the usual causative organism in acute osteomyelitis
Staph aureus or Haemophilus in children
What is the usual antibiotic given if required
Flucloxacillin
What should be done if there is devascularised bone in the body
It needs to be removed and so you may have to make the wound bigger to remove it
What is the treatment plan for acute osteomyelitis
If there is pus - let it out
Do not just give antibiotics
How does chronic osteomyelitis come about
Bugs can lie dormant for a long time
Elevated periosteum will eventually try and compensate for the dying central bone - you get bone forming on the outside
What are the useful investigations for chronic osteomyelitis
Xray and MRI
What is Involucrum
Involucrum is a layer of new bone growth outside existing bone seen in pyogenic osteomyelitis. It results from the stripping off of the periosteum by the accumulation of pus within the bone, and new bone growing from the periosteum
What is a common presentation for a patient with septic arthritis
Very painful - cannot move the area at all
What does septic arthritis do to the articular cartilage
It destroys it pretty quickly
What are biofilms
Slime forming organisms
They get in early and start creating a slimy layer
usually commensal organisms
On an X Ray what should you be suspicious of if there is a dark line around the bone
Infection
What determines how successful surgery to clean the joint is
The bug
The host
The quality of surgical excision
What is the prophylaxis for joint surgery
Easily measurable Clean air theatres local antibiotics systemic antibiotics duration of surgery Neat surgery Quality of hand washing Theatre discipline Antibiotics in cement
