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Musculoskeletal System > Bone and Soft Tissue Infection > Flashcards

Bone and Soft Tissue Infection Flashcards

1
Q

What is osteomyelitis?

A

Bone infection

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2
Q

Risk factors of osteomyelitis

A 
Mostly children
Boys > girls
History of trauma
Other disease
   - Diabetes
   - Rheumatoid arthritis
   - Immune compromise
   - Long term steroid treatment
   - Sickle cell
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3
Q

Osteomyelitis source of infection

A

Haematogenous spread
Local spread from contiguous site of infection – trauma
Secondary to vascular insufficiency

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4
Q

Acute osteomyelitis organisms < 1 year

A

Staph aureus
Group B streptococci
E. coli

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5
Q

Acute osteomyelitis organisms older children

A

Staph aureus
Strep pyogenes
Haemophilus influenzae

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6
Q

Acute osteomyelitis organisms adults

A

Staph aureus

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7
Q

Acute osteomyelitis pathology

A

Starts at metaphysis
Acute inflammation – increased pressure
Necrosis of bone
New bone formation

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8
Q

Presentation of acute myelitis (infant)

A 
May be minimal signs, or may be very ill
Failure to thrive
Poss. drowsy or irritable
Metaphyseal tenderness + swelling
Decrease ROM
Positional change
Commonest around the knee
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9
Q

Presentation of acute myelitis (child)

A 
Severe pain 
Reluctant to move
Fever + tachycardia
Malaise
Toxaemia
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10
Q

Presentation of acute myelitis (adult)

A

Primary OM seen commonly in thoracolumbar spine
Backache
History of UTI or urological procedure
Elderly, diabetic, immunocompromised

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11
Q

Soft tissue infection

A 
Cellulitis
Erysipelas
Necrotising fasciitis 
Gas gangrene 
Toxic shock syndrome
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12
Q

Acute osteomyelitis diagnosis

A

X-ray
Ultrasound
Aspiration
MRI

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13
Q

Sequestrum

A

Late osteonecrosis

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14
Q

Involucrum

A

Late periosteal new bone

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15
Q

Acute osteomyelitis

A

Supportive treatment for pain and dehydration
Rest & splintage
Antibiotics
Surgery

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16
Q

Chronic osteomyelitis organisms

A

Often mixed

mostly:
Staph. Aureus
E. Coli
Strep. pyogenes
Proteus
17
Q

Chronic osteomyelitis treatment

A

Long-term antibiotics
Eradicate bone infection- surgically
Treat soft tissue problems

18
Q

What is septic arthritis?

A

Joint infection

19
Q

Acute septic arthritis route of infection

A 
Haematogenous
Eruption of bone abscess
Direct invasion
   - Penetrating wound
   - Intra-articular injury
   - Arthroscopy
20
Q

Septic arthritis organisms

A

Staphylococus aureus
Haemophilus influenzae
Streptococcus pyogenes
E. coli

21
Q

Acute septic arthritis pathology

A

Acute synovitis with purulent joint effusion
Articular cartilage attacked by bacterial toxin and cellular enzyme
Complete destruction of the articular cartilage

22
Q

Acute septic arthritis sequelae

A

Complete recovery
Partial loss of the articular cartilage and subsequent OA
Fibrous or bony ankylosis

23
Q

Neonatal presentation of acute septic arthritis

A

Picture of septicaemia =>
Irritability
Resistant to movement
Ill

24
Q

Child/adult presentation of acute septic arthritis

A

Acute pain in single large joint
Reluctant to move the joint
Increase temp. and pulse
Increase tenderness

25
Q

What is the most common cause of acute septic arthritis in adults?

A

Infected joint replacement

26
Q

Acute septic arthritis treatment

A

General supportive measures

Antibiotics

27
Q

Classification of TB bone and joint

A

Extra-articular (epiphyseal / bones with haemodynamic marrow)
Intra-articular (large joints)
Vertebral body

28
Q

TB clinical presentation

A 
Insidious onset &amp; general ill health
Contact with TB
Pain (esp. at night), swelling, loss of weight
Low grade pyrexia
Joint swelling
Decrease ROM
Ankylosis 
Deformity
29
Q

TB pathology

A

Primary complex (in the lung or the gut)
Secondary spread
Tuberculous granuloma

30
Q

Spinal tuberculosis presentation

A

Little pain

Present with abscess or kyphosis

Musculoskeletal System (19 decks)

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