bone infections Flashcards
what should be assumed for an acute monoarthritis
assume it is septic arthritis and then aspirate to test
how does the infection usually get to the joint
haematogenous spread
risk factor for bone infection
age pre-existing joint disease diabetes mellitus immunosuppression ivdu sti
clinical features of septic arthritis
acute monoarthritis
fever
swollen hot and red joint
usually knee and hip
most common pathogen of septic arthritis
is staph aureus
a common pathogen of septic arthritis in sexually active adults
disseminated gonococcal infection from untreated gonorrhoea
pathogens that can cause septic arthritis in elderly and IVDU
gram negative bacilli or strep
pathogens that can cause septic arthritis in neonates
strep and staph
investigation for septic arthtiris
-aspirate joint and culture synovial fluids
-fbc
-blood cultures
-lft
u and e
esr and crp
management of septic arthritis
- aspirate the joint
- blood culture and other swabs
- empirical antibiotics=flucoxacillin or in elderly add cephalosporin or gentamicin
- analgesia
- aspirate the joint one or twice daily
- consult for a wash out
what other disease can septic arthritis prevent in
lyme disease by borrelia
how does viral arthritis present
polyarthritis following a febrile illness and may have a rash
most common cause of viral arthritis in the UK
parvovirus=slapped cheek
dx of parvovirus
IgM antibodies
musculoskeletal manifestation of HIV
- sjorgen like disease
- vasculitis
- reactive arthritis
- psoriatic arthritis
- non specific arthralgia
what is osteomyelitis
infection in the bone and bone marrow often at the juxta epiphyseal region of long bones
usual pathogens causing osteomyelitis
staph
pseudomonas
tb
risk factor for osteomyelitis
- childhood
- immunodeficiency
- diabetes mellitus
- sickle cell disease-salmonella
sequestrum of osteomyeltisi
osteonecrosis and eventual perforation of the cortex by pus stimulating new bone formation in the periosteum leading to sinus and skin discharge
how long do empirical antibiotics for an SAB have to be given
2 WEEKS!!
Complications of osteomyelitis
chronic osteomyelitis
secondary amyloidosis and skin malignancy
where does tb infection usually target
- spine Pott’s disease or large joint
- pain swelling and fever
