Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Bone and Soft Tissue Infection > Flashcards

Bone and Soft Tissue Infection Flashcards

1
Q

2 types of osteomyelitis

A

-Primary
-Secondary
(acute + chronic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who’s likely to get acute osteomyelitis

A
  • Mostly children
  • Boys>girls
  • Hx of minor trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Source of infection in osteomyelitis

A
  • Haematogenous spread (children + elderly)

- Local spread from contiguous site of infection (surgery/open fracture/joint replacement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Common sources of infection in:

  • Infants
  • Children
  • Adults
A
  • Infants = Infected umbilical cord
  • Children = Tonsilitis, skin abrasions and boils
  • Adults = UTI, Arterial line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Common organism causing acute osteomyelitis

A

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Organism causing acute osteomyelitis in sickle cell disease

A

Salmonella spp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pathology of acute osteomyelitis

A
  • Starts at metaphysis
  • Vascular stasis (venous congestion + arterial thrombosis)
  • Acute inflammation - increased pressure
  • Suppuration
  • Necrosis of bone (sequestrum)
  • New bone formation (involucrum)
  • Resolution or chronic osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe acute osteomyelitis in long bones

A

Starts in metaphysis

  • Distal femur
  • Proximal tibia
  • Proximal humerus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical features of acute osteomyelitis in infants

A
  • May be very ill or appear well
  • Failure to thrive
  • Poss. drowsy or irritable
  • Metaphyseal tenderness + swelling
  • Decrease ROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical features of acute osteomyelitis in children

A
  • Severe pain
  • Reluctant to move/not weigh bearing
  • Maybe be tender fever (swinging pyrexia) + tachycardia
  • Malaise (fatigue, nausea, vomiting)
  • Toxaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clinical features of primary acute osteomyelitis in adults

A
  • Seen commonly in thoracolumbar spine
  • Backache
  • Hx of UTI or urological procedure
  • Elderly, diabetic, immunocompromised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical features of secondary acute osteomyelitis in adults

A
  • Secondary much more common that primary
  • Often after open fracture, surgery (esp. Open Reduction External Fixation ORIF)
  • Mixture of organisms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to diagnose acute osteomyelitis

A
  • Hx + examination (HR + temp.)
  • FBC + diff WBC
  • ESR, CRP
  • Blood cultures x 3 (at peak temp.)
  • U&Es
  • X-ray (normal in the first 10-14 days)
  • Ultrasound
  • Aspiration
  • Isotope bone scan
  • MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acute osteomyelitis diff diagnosis

A 
Common
-Acute septic arthritis 
-Trauma (fracture, dislocation)
-Acute inflammatory arthritis 
-Transient synovitis
-Soft tissue infection
Rare
-Sick cell crisis 
-Gaucher's disease 
-Rheumatic fever 
-Haemophilia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is seen on a X-ray in acute osteomyelitis

A

Increasing Metaphyseal destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of acute osteomyelitis

A
  • Supportive pain + dehydration
  • Rest + splintage
  • Antibiotics
17
Q

Describe the antibiotic treatment of acute osteomyelitis

A

-IV or Oral
-4-6 week duration (depends on response, ESR)
-Empirical while waiting
Must consider
-Spectrum of activity
-Penetration to bone
-Safety for long term administration

18
Q

Empirical antibiotics for acute osteomyelitis

A

Flucloxacillin + Benzylpenicillin

19
Q

Complications of osteomyelitis

A
  • Septicaemia/death
  • Metastatic infection
  • Septic arthritis
  • Pathological fracture
  • Chronic osteomyelitis
  • Altered bone growth
20
Q

Clinical features of subacute osteomyelitis

A
  • Long Hx (weeks/months)
  • Pain/Limp
  • Local swelling/warmth occasionally
  • Tenderness
21
Q

DDx for subacute osteomyelitis

A
  • Tumour (Ewing’s sarcoma, osteoid osteoma)

- TB

22
Q

Presentation of Brodie’s abscess and a DDx

A
  • Subacute osteomyelitis
  • Older children
  • Painful limp, no systemic features
  • DDx = Ewing’s sarcoma
23
Q

What’s shown on a X-ray of Brodie’s abscess

A

Radiographic lucency in long bone metaphysis

24
Q

Treatment of Brodie’s abscess

A

Curettage

25
Q

Investigations for subacute osteomyelitis

A
  • X-ray
  • Bone scan
  • Biopsy (50% +ve) grow organism
26
Q

Treatment of subacute osteomyelitis

A
  • Prolonged course of antibiotic

- Curettage

27
Q

Cause of chronic osteomyelitis

A 
-May follow acute osteomyelitis 
May start de novo
-Following surgery 
-Immunocompromised, diabetics, elderly, drug abusers 
-Usually staph aureus or e. coli
28
Q

Treatment of chronic osteomyelitis

A
  • Long-term antibiotics (local or systemic)
  • Eradicate bone infection surgically (multiple operations)
  • Amputation?
  • Massive reconstruction?
29
Q

What local and systemic antibiotics are used to treat osteomyelitis

A
  • Local = Gentamicin cement/beads or collatamp (fully re-absorbable, gentamicin-impregnated collagen “sponge”
  • Systemic = Oral/IV/home AB
30
Q

Chronic osteomyelitis complications

A
  • Chronically discharging sinus + flare-ups
  • Ongoing (metastatic) infection (abscesses)
  • Growth disturbance + deformities
  • Pathological fracture
  • Squamous cell carcinoma

MSK (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions