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Y3 - MusculoSkeletal > Bone and Soft tissues infections > Flashcards

Bone and Soft tissues infections Flashcards

1
Q

bone infection

A

osteomyelitis

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2
Q

joint infection

A

septic arthritis

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3
Q

acute osteomyelitis is common in

A

children

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4
Q

sources of infection:

A

haematogenous spread

local spread from site (bone fracture, bone surgery, joint replacement)

secondary to vascular insufficiency

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5
Q

organisms causing the infection in infants

A

staph aureus

group B strep

E.coli

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6
Q

organisms causing the infection in children

A

staph aureus

haemophilus influenzae

strep pyogenes

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7
Q

organisms causing the infection in adults

A

staph aureus

TB

pseudomonas aeruginosa

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8
Q

clinical features of acute osteomyelitis in infants

A

failure to thrive

possible drowsiness or irritable

metaphyseal tenderness or swelling

decreased range of motion

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9
Q

clinical features of acute osteomyelitis in children

A

severe pain

reluctant to move

tender fever (swinging pyrexia)

malaise

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10
Q

how do you diagnose acute osteomyelitis?

A

history and clinical exam (pulses and temp)

FBC/ WBC

blood culture

ESR/ CRP

X-ray

USS

aspiration

isotope bone scan

labelled white cell scan

MRI

blood cultures

bone biopsy is gold standard in pathogen identifying

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11
Q

differential diagnosis for acute osteomyelitis

A

acute septic arthritis

acute inflammatory arthritis

trauma

transient synovitis

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12
Q

what is cellulitis?

A

deep infection of the subcutaneous tissues

group A strep

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13
Q

name some common soft tissue infections:

A

cellulitis

erysipelas

necrotising fasciitis

gas gangrene

toxic shock syndrome

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14
Q

sequestrum

A

dead bone

usually found in chronic bone disease

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15
Q

involucrum

A

layer of new bone outside the existing bone

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16
Q

how do you treat acute osteomyelitis?

A

supportive for pain and dehydration

rest and splint-age

antibiotics

17
Q

ESR that is faster than normal ESR can show what?

A

there is inflammation

18
Q

osteomyelitis complications

A

septicemia, death

metastatic infection

pathological fracture

septic arthritis

chronic osteomyelitis

altered bone growth

19
Q

most common organisms that cause chronic OM

A

staph aureus

E coli

strep pyogenes

20
Q

route of infection for septic arthritis

A

haematogenous

eruption of bone abscess

direct invasion (injury etc)

21
Q

organisms responsible for acute septic arthritis

A

Staph aureus

haemophilus influenzae

strep pyogenes

e coli

22
Q

2 key pathologies that occur in acute septic arthritis:

A

acute synovitis with purulent joint effusion

complete destruction of articular cartilage

23
Q

synovitis

A

inflamed synovial membrane

24
Q

ankylosis

A

abnormal stiffening and immobility of a joint due to fusion of the bones

25
Q

3 outcomes of sequelae occurring in acute septic arthritis

A

complete recovery

partial loss of the articular cartilage and subsequent OA

fibrous or bony ankylosis

26
Q

acute septic arthritis is more common in

A

children

27
Q

how do you investigate acute septic arthritis?

A

FBC - WBC, ESR, CRP, blood cultures

X-ray

USS

aspiration

28
Q

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

A

infected joint replacement

29
Q

differentials for acute septic arthritis

A

acute osteomyelitis

trauma

irritable joint

haemophilia

rheumatic fever

gout

30
Q

arthroplasty

A

surgical reconstruction or replacement of a joint

31
Q

how do you treat acute septic arthritis?

A

general supportive measures

antibiotics (3-4 weeks)

surgical drainage and lavage (emergency - never let the sun set on pus)

infected joint replacement

32
Q

clinical features of TB in the bones and joints

A

insidious onset and general ill health

pain (esp at night), swelling, loss of weight

low grade pyrexia

decreased range of motion

ankylosis

deformity

33
Q

what is tuberculosis of the bones a type of?

A

specific osteomyelitis

34
Q

how do you identify the pathogen in osteomyelitis?

A

bone biopsy is the gold standard

35
Q

differentials for TB:

A

monoarticular rheumatoid arthritis

transient synovitis

tumour

36
Q

how would you investigate TB in the bones and joints?

A

Mantoux test

FBC/ ESR

sputum/ urine culture

X-ray (soft tissue swelling, articular space narrowing)

Joint aspiration and biopsy

37
Q

how do you treat TB of the bones?

A

chemo

rest and splint-age

38
Q

in a neonate- if they are ill, reluctant to move and irritable - what does this strongly indicate?

A

septicaemia

Y3 - MusculoSkeletal (13 decks)

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