Bone infection

Question 1

What predisposes people to acute osteomyelitis

Answer 1

Child
Boys> Girls
History of trauma OR diabetes, rheumatoid arthritis, immune compromise, long term steroid treatment, sickle cell

Question 2

What is the source of infection of osteomyelitis?

Answer 2

Haematogenous spread

Local spread from contiguous site of infection

Secondary to vascular insufficiency

INFANTS - infected umbilical cord

CHILDREN - boils, tonsilitis, skin abrasions

ADULTS - UTI, Arterial line

Question 3

What is the most common organism of osteomyelitis?

Answer 3

Staph aureus, Group B strep, E. Coli, Staph pyogenes, haemophilus influenza

Question 4

What are the clinical features of acute osteomyelitis in an infant?

Answer 4

Failure to thrive, possibly drowsy or irritable, metaphyseal tenderness and swelling, decrease ROM, positional change, commonest around knee

Question 5

What are the clinical features of acute osteomyelitis in a child?

Answer 5

Severe pain, reluctant to move, not weight bearing, may be tender fever and tachycardic, malaise, toxaemia

Question 6

What are the clinical features of osteomyelitis in an adult?

Answer 6

Primary OM seen commonly in thoracolumbar spine, backache, history of UTI or urological procedure

Question 7

How do you diagnose acute osteomyelitis?

Answer 7

History and clinical examination, FBC, WCC, ESR, CRP, Blood cultures, U/Es

X-Ray, US, Aspiration, Isotope Bone Scan, Labelled White Cell Scan, MRI

Bone Biopsy, Tissue Swabs

Question 8

What is the treatment of acute osteomyelitis?

Answer 8

General care and analgesia, rest and splintage, antibiotics (fluclox and benzylpen), Surgery, Infected Joint Replacement

Question 9

What are complications of acute osteomyelitis?

Answer 9

Septicemia, metastatic infection, pathological fracture, septic arthritis, altered bone growth, chronic osteomyelitis, death