Bone and Joint Infection Flashcards
What does “calor” mean?
Heat
What does “dolor” mean?
Pain
What does “tumor” mean?
Swelling
What does “rubor” mean?
Redness
What does “functio laesa” mean?
Loss of function
What is important when getting specimen from hip infection?
To have x-ray control
What two blood tests used together are useful for infection?
CRP and Plasma viscosity
What can bone scans show/measure?
Osteoblasts
What can MRI show in infection?
Can see pus on MRI picture - ABCESS
On MRI, what colour would inflammation show up?
White
Is acute osteomyelitis common in UK?
No, pretty rare in UK, but v common in some other countries
Where does acute osteomyelitis in children or immunosuppressed come from?
“Haematogenous”
originating in or carried by the blood.
What does Haematogenous mean?
Originating in or carried by the blood.
What is the cause of MOST cases of acute osteomyelitis? (method of infection)
Post-traumatic/open wound
Which organism is the cause of MOST cases of acute osteomyelitis? (adults)
Staph aureus
Which organism is the cause of most cases of acute osteomyelitis IN CHILDREN?
Haemophilus
What are the three factors of Virchow’s Triad?
Endothelial Injury
Stasis of Bloodflow
Hypercoagulability
Can you treat abcess with antiobiotics alone?
No
if there’s any pus, let it out
Are bloodtests helpful with chronic osteomyelitis?
Often not
Plain X rays and MRI more helpful
What is an INVOLUCRUM?
A layer of new bone growth outside existing bone. It results from the stripping-off of the periosteum by the accumulation of pus within the bone, and new bone growing from the periosteum.
In an involucrum, what is producing new bone?
The PERIOSTEUM (a dense layer of vascular connective tissue enveloping the bones except at the surfaces of the joints)
Is septic arthrits an emergency?
YES
What are the causes of septic arthritis? (method of infection)
Inoculation
Metaphyseal spread
Direct haemaatogenous
What does gas in tissue on x-ray show?
black spots
That there’s a as-forming organism inside tissue - Necrotising fasciitis (will kill quickly)
What is a curette used for?
Biopsy and drainage
What is “debridement”?
The removal of damaged tissue or foreign objects from a wound.
What is discitis?
Septic arthritis of intervertebral disc space
can occur in children
Is infected arthroplasty a deep infection or a superficial wound problem?
Deep infection
What is “arthroplasty”?
The surgical reconstruction or replacement of a joint.
What tests would you conduct for an infection arthroplasty?
CRP
Joint aspiration
Bone scan (Technetium 99)
X Ray
What are “biofilms”?
A thin but robust layer of mucilage adhering to a solid surface and containing a community of bacteria and other microorganisms.
A lot of infections are from commensals which form slime and are gram positive.
Common in the oil industry
If there’s pus in an infected joint, how do you treat?
Let pus out!
What measures are taken to prevent “bad air” getting into a wound, reducing risk of infection, during surgery?
“Clean air theatres”
What prophylactic measures taken to prevent infection of wounds?
Clean air theatres Local antibiotics Systemic antibiotics Duration of surgery considered Neat surgery Quality of hand washing considered Theatre discipline
Which bugs commonly cause infected prosthesis?
Staph aureus (SA) Staph epidermidis (SE = Coagulase Negative Staphylococcus (CNS)
