Bone & Joint Infections

Question 1

List the organisms in order of frequency of cases caused that are responsible for osteomyelitis.

Answer 1

S. aureas (80%)
S. pyogenes
M. tuberculosis
(Salmonella*)

Question 2

List some of the symptoms and signs that are present in cases of osteomyelitis.

Answer 2

Fever
Painful, swollen site
Paraplegia
Reduced movement

Question 3

What is C-reactive protein?

Answer 3

A protein present in blood plasma which increases in number upon inflammation

Question 4

Name the 4 investigations that are carried out when diagnosing osteomyelitis.

Answer 4

X-ray
CT/MRI/Bone Scan
Blood sample
Pus

Question 5

How is osteomyelitis treated?

Answer 5

Standard empirical:
FLUCLOXACILLIN, fucidin

Alternative empirical:
Fucidin, erythromycin
*Ciprofloxacin (salmonella)
Isoniazid, Rifampicin, Pyrazinamide, Ethambutol (tuberculosis)

Question 6

Where is septic arthritis most likely to occur (three sites)?

Answer 6

Knee
Hip
Lumbo-sacral Spine

Question 7

List three predisposing conditions to septic arthritis.

Answer 7

Rhumatoid arthritis
Infection of joint
Prosthetic joint

Question 8

Name some causative organisms of septic arthritis.

Answer 8

S. aureus
S. pyogenes
M. tuberculosis
S. epidermis
Salmonella
Brucella

Question 9

Which three methods are used to diagnose septic arthritis?

Answer 9

Blood culture
Joint aspirate (i.e. drain fluid from joint)
Joint X-ray

Question 10

How is septic arthritis treated?

Answer 10

Standard Empirical:
FLUCLOXACILLIN, fucidin

Alternative Empirical:
Erythromycin

Question 11

What is Reiter’s Syndrome?

Answer 11

Arthritis, conjunctivitis & urethritis

Possibly caused by chlamydia

Question 12

Where do organisms settle in the bone in haematogenous spread?

Answer 12

Metaphysis

Question 13

For salmonella based osteomyelitis, what is the most common predisposition?

Answer 13

Sickle cell disease

Question 14

For brucella based osteomyelitis, what is the most common predisposition?

Answer 14

Travel/Foreign born

Question 15

What type of organism based osteomyelitis is likely to arise in children under the age of 5 years?

Answer 15

H. influenzae based

Question 16

Which type of organism based osteomyelitis is most likely to arise in people with cases of prosthesis (i.e. prosthetic limbs)?

Answer 16

S. epidermis

Question 17

E. coli based osteomyelitis is most likely to arise from what predisposition?

Answer 17

UTI (urinary tract infection)