Bone/Joint infections Flashcards
Osteomyelitis
- what is it?
Infection of the bone
What are 3 ways that osteomyelitis can come about?
Haematogenous spread
Contiguous spread
Direct inoculatio (trauma surgeru)
In haematogenous spread to osteomyelitis, what is normaly affected, why?
Metaphysis due to slow blood flow in metaphyseal vascular loops
How does haematogenously spread osteomyelitis normally present?
Pus discharge from sinues
Who is at risk of haematogenous OM?
Infants and young children Elderly patients IV drug abusers Central venous catheters Joint disease Immuno-supression Trauma
Most common cause of haematogenous OM in neonates, children and adults?
S. aureus
In those with sickle cell disease/thalassaemia, what is most common micro-org responsible for haematogenous OM?
Salmonella species
Implant associated infections OM, most common microorg?
Coagulase-neg staphylococci
Radiography findings in OM?
2 week lag. Soft tissue swelling, periosteal thickening and focal osteopenia
What test can rule out OM?
Negative technetium diphosphonate test
3 primary sites for OM form contiguous spread?
Cellulitis
Septic arthritis
Diabetic foot infections
Septic arthritis
Similar to OM, what is an additional risk factor for SA specifically?
Steroid injection
Surgical treatment of SA?
Aspirate arthroscopic drainage or open washout
Medical treatment of SA?
Risk of N gon or E coli?
MRSA risk?
Flucloxacillin. alt clindeamicin
Ceftriaxone
Vancomycin
Prosthetic joint infections
- presentation?
Radiography?
Discharging sinus
Lucencies around prostheses
