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LOCO 2 > Bone and joint infection > Flashcards

Bone and joint infection Flashcards

1
Q

In what ages is septic arthritis usually seen

A

Extremes of age- older than 65 or the very young

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2
Q

Is it ususally mono-articular or poly-articular

A

Mono

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3
Q

How does septic arthritis usually present

A
  • Red
  • Swelling
  • Inflammation
  • Fever
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4
Q

What bacteria usually give a ‘cold inflammatory process’

A

Microplasma such as TB

Slow growing

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5
Q

Why does septic arthritis happen more in elderly

A

More likely to have osteoarthritis- more injections/ procedures

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6
Q

How do the majority of infections get to the joint capsule in septic arthritis

A

Via the blood supply

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7
Q

What organism most commonly leads to septic arthritis

A

Staph aureus

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8
Q

Name some other common organisms which can lead to bone/ joint infection

A

Streptococci pneumoniae/ group B. pyogenes

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9
Q

How do the microorganisms lead to bone/ joint infections

A

Activation of macrophages/ T/ B cells lead to damage of the joint

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10
Q

3 potential causes of bone/ joint infections

A

Previous damage to joint
Untreated systemic infection
Conditions that affects blood supply to the joint

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11
Q

What is the most commonly affected joint in septic arthritis

A

Knee

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12
Q

What joints are infrequently affected by septic arthritis

A

Wrist, shoulder, fingers

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13
Q

Describe the lab findings for somebody with septic arthritis

A
  • Elevated ESR

- Neutrophilia (esp in children)

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14
Q

How will synovial fluid appear in bone/ joint infection

A

Turbid/ purulent
Gram stain positive
Low glucose level
Leukocytes

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15
Q

In what % of septic arthritis cases are blood culture positive

A

1/3

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16
Q

Describe the radiological findings of somebody with septic arthritis

A
  • Initially not useful- may see some soft tissue swelling
  • Joint capsule distension depending on
  • Erosition of articular cartilage and soft tissue swelling
17
Q

When do you see destructive changes radiologically in somebody with septic arthitis

A

After 2 weeks

18
Q

What do you see radiologically in myobacterial infection?

4

A

Joint space narrowing
Effusion
Erosion
Cyst formation

19
Q

Differential diagnoses for septic arthritis

A

Acute rheumatoid arthritis
Gout/ pseudogout
Chondrocalcinosis

20
Q

How do you treat septic arthritis

A

Drainage

Broad spectrum antibiotics asap and then modify depending on gram stain

21
Q

How long will septic arthritis patients be on IV antibiotics for

A

3-4 weeks

22
Q

When does reactive arthritis occur

A

Post infection

23
Q

How do osteomyeltitis usually spread

A

Haemotagenous spread

24
Q

What usually causes osteomyelitis in adults

A

Trauma (open fracture)

25
Q

What are the consequences of osteomyelitis

A

Abcess on the metaphyseal side of the growth plate

Makes bone around the abcess to try and keep it from the healthy tissue

26
Q

What are the 2 general predisposing factors for osteomyelitis

A

Impairment of immune surveillance

Impairment of local vascular supply

27
Q

What impairments of the immune surveillance can lead to osteomyelitis

A

Malnutrition

Extremes of age

28
Q

What impairments of vascular supply can lead to osteomyelitis

A

Diabetes
Venous statis
Radiation fibrosis
Sickle cell disease

29
Q

Describe the clinical features of osteomyelitits

A 
Hametogenous long bone
Abrupt onset of fever
Decreased limb movement
Local non specific pain
Elevated neutrophil and ESR
30
Q

What is the result of chronic osteomyelitits

A

Local bone loss and persistent draingage through the sinus

31
Q

How do you investigate chronic osteomyelitis

A

Bone biopsy
Blood cultures
Neutrophil count
ESR

32
Q

How is osteomyelitis managed surgically

A

Debirdement to remove teh seqeustrum ( dead bone)

Reconstruct the bone

33
Q

How long must a person be on antibiotics for chronic osteomyelitis

A

4-6 weeks

34
Q

What is involcrum

A

The new bone that has been remodelled

35
Q

How does prosthetic bone and joint infection occur

A
  • Occurs in the osteous tissue adjacent to prosthesis at the bone/ cement interface
  • Results from local inoculation at surgery or post-op spread from wound sepsis

LOCO 2 (25 decks)

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