Brainscape's Knowledge GenomeTM

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


See full index

Musculoskeletal > Bone & Joint infection > Flashcards

Bone & Joint infection Flashcards

1
Q

What is osteomyelitis?

A

Inflammation of bone tissue as a result of infection

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

Who gets osteomyelitis?

A

Older people generally

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

What are the risk factors of osteomyelitis?

A

Type II diabetes

Peripheral vascular disease

Pre-existing bone/joint problem

  • arthritis
  • prostheses

Immunodeficiency

Bacteraemia

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

Osteomyelitis is rare.

True or false?

A

True

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

Name the ways an infection can be introduced into the bone?

A
  1. Direct Inoculation
  2. Contiguous spread (local)
  3. Haematogenous spread
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does direct inoculation cause osteomyelitis?

A

Infection gets in when the bone is damaged

Needs to be a hole in the bone for the infection to get in

Infection goes in and establishes itself inside the bone

Usually a result of trauma or surgery

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

How does contiguous spread cause osteomyelitis?

A

Infection spreads from adjacent soft tissues and joints

Often it begins as a cellulitis and spreads to the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does haematogenous spread cause osteomyelitis?

A

Bacteria reach the bone by traveling through the blood stream from another site in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What features of a bacteria make it more able to infect bone?

A

Microbial surface components that adhere to bone matrix molecules like:

  • collagen
  • fibronectin
  • fibrinogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which bacteria is often responsible for osteomyelitis?

A

Staph. aureus
Streptococcus species
Enterobacter species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which bacteria is associated with osteomyelitis in children?

A

Haemophilus influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which species of bacteria is associated with osteomyelitis in the immunosuppressed and IV drug users?

A

Pseudomonas species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Osteomyelitis can be acute or chronic.

What would you see looking down a microscope at a biopsy of bone affected by acute osteomyelitis?

A

Inflammatory cells
Oedema
Vascular congestion
Small vessel thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Osteomyelitis can be acute or chronic.

What would you see looking down a microscope at a biopsy of bone affected by chronic osteomyelitis?

A

Necrotic bone: sequestra

New bone formation: involucrum

Neutrophil exudates

Lymphocytes and histiocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical features of osteomyelitis?

A

Local:

  • dull pain
  • tenderness
  • warmth
  • erythema
  • swelling

Systemic:

  • fever
  • rigors
  • sweats
  • malaise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What would you see in a case of chronic osteomyelitis?

A

Hardened, woody skin

Erythema

Swelling

Deep, large ulcers that fail to heal

Non-healing fractures

Sinus formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where in the body does osteomyelitis most often occur?

A

Hip
Vertebrae
Pelvis

18
Q

Investigation of osteomyelitis?

A

Blood:

  • raised WBC count
  • raised ESR/CRP
  • blood cultures

Imaging:

  • X-rays normal initially, new bone is formed soon however which is visible
  • shows up marrow oedema + inflammation

Bone biopsy:

  • 2 specimens
  • microbiology test on them
  • look under microscope to see inflammation + necrosis
19
Q

Management of osteomyelitis?

A

Analgesia

Support for the limb, splint

Antibiotics

Drainage of abscess if there is one

Removal of dead bone

Amputation of very severe

20
Q

How do you choose which antibiotics to treat osteomyelitis with?

A

Which ones are appropriate for the microbe

Which one can penetrate bone and soft tissue best

21
Q

What is TB osteomyelitis?

A

It is an extra-pulmonary manifestation of TB

22
Q

Where does TB osteomyelitis mostly affect?

A

It often affects vertebrae

23
Q

What is sequestrum?

A

Dead bone

24
Q

What is involucrum?

A

Periosteal new bone which forms around the sequestrum (dead bone)

25
Q

What is the epiphysis?

A

The head of a long bone

26
Q

What is the diaphysis?

A

The shaft of a long bone

27
Q

What is the metaphysis?

A

The bit between the epiphysis and the diaphysis

28
Q

What is the official name for joint infection?

A

Septic arthritis

29
Q

Why does septic arthritis need to be treated quickly?

A

It can destroy a joint in 24 hours

Very destructive and quickly developing disease

30
Q

Which type of joints are affected in septic arthritis?

A

Synovial

31
Q

Who gets septic arthritis?

A

More often in children, young adults and the elderly (above age 80)

32
Q

What are the risk factors of septic arthritis?

A

Bacteraemia

Pre-existing joint disease:

  • RA
  • OA

Diabetes

Immunosuppression

Recent joint surgery

Prosthetic joints

IV drug abuse

33
Q

Which bacteria are the most common cause of septic arthritis?

A

Staph aureus

34
Q

Which pathogens are common causes of septic arthritis in the immunocompromised?

A

Gram negative bacteria
Mycobacterium
Fungi

35
Q

What is gonococcal arthritis?

A

Septic arthritis caused by a disseminated gonococcal infection

36
Q

Clinical features of gonococcal arthritis?

A

Polyarthritis
Tenosynovitis
Fever

Maculopapular rash:
- common in peripheries

37
Q

Clinical features of septic arthritis?

A

Acute development

Inflammation of joint:

  • pain
  • red
  • swollen
  • hot
  • children may not use joint

Fever

38
Q

Septic arthritis is most commonly polyarthritis.

True or false?

A

False

90% of the time it is mono-arthritic

39
Q

Investigation of septic arthritis?

A

Blood:

  • ESR + CRP raised
  • WBC raised

X-ray:
- normal initially, joint damage will show later

USS: may show any effusion

Aspirate joint:

  • culture aspirate
  • look for crystals to rule out gout
40
Q

What is the most important thing to do when you suspect someone may have septic arthritis?

A

Aspirate the joint
Collect the fluid
Send it off for analysis, culturing

41
Q

Management of septic arthritis?

A

Aspiration

Antibiotics chosen after aspirate has been cultured
Long course: 6 weeks minimum

Analgesia

Promptly refer for joint washout, repeated aspiration until no further effusion

Figure out how the infection got in and amend it

If joint is too damaged consider replacement, debridement, amputation

42
Q

What does debridement mean?

A

Removal of dead or damaged tissue

Musculoskeletal (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions