Bone & Joint Infection Flashcards
What are the 5 characteristics of inflammation which are often also seen in infection?
Rubor Calor Dolor Tumor Functio laesa
Empirical antibiotics should be given to the patient to cover the period whilst you are awaiting lab culture results. TRUE/FALSE?
FALSE
Don’t start antibiotics until you know what you’re treating
What are the most useful blood tests in bone and joint infection?
C Reactive protein (CRP)
Plasma viscosity
Why is a blood culture not always useful?
Not all bone and joint infections cause a bacteraemia/septicaemia
=> nothing will be cultured from the blood
What is a Brodie’s abscess and how does this appear on X-Ray imaging?
subacute osteomyelitis (usually caused by staph. aureus)
On X-Ray:
- lytic lesion
- oval configuration
- oriented along the long axis of the bone
- usually in metaphysis
What agent is used in bone scans?
technetium
What infections of bone and joints are the most clinically relevant?
Acute osteomyelitis Chronic osteomyelitis Septic arthritis Soft tissue infections The infected arthroplasty
What are the most common causes of osteomyelitis?
Mostly post-traumatic/open
= inoculation
Then children or immunosuppressed
= haematogenous
What microbe usually causes acute osteomyelitis?
Staph aureus
Haemophilus in children
If theres pus, let it out. TRUE/FALSE?
TRUE!
If the skin around a chronic osteomyelitic lesion needs excised, what can be done surgically to improve the rate of recovery?
Muscle and skin graft
the blood supply to the muscle allows antibiotic penetration to the wound => healling faster
How does septic arthritis usually occur
From inoculation
From metaphyseal spread
Direct haematogenous
Give examples of soft tissue infection
Cellulitis
Plantar fasciitis
Necrotising fasciitis
What antibiotics are best used in cellulitis?
Staph. and Strep. cover
e.g. flucloxacillin and benzylpenicillin
In what cases of soft tissue infections would you operate?
Operate if there is dead tissue or foreign body
