Bone & Soft Tissue Infection & Tumours Flashcards
What is osteomyelitis?
It is the infection of the bone
What is the most common causative organism of osteomyelitis?
Staphylococcus aureus
What are some of the other causes of osteomyelitis?
E. coli
Pseudosmonas
Streptococcus
Who tends to get osteomyelitis ?
Children
What are the symptoms and signs of osteomyelitis?
Systemically Unwell Bone pain Abscess Drowsy Fever Irritable Reluctant to weight bear
What are the investigations of OM?
Blood culture x 3
FBC, WBC, ESR, CRP
X-ray and aspiration
What are the management options fro OM?
Supportive treatment
Dehydration
Antibiotics
Fluxloxacillin and benzyslpenacillin whilst waiting for blood work results
May need surgical aspiration/ pus removal
What is septic arthritis?
This is a medical emergency where there is infection of the joint
What is the causative organism? What are some of the less common ones?
Staphylococcus aureus
Streptococci, HI
What are the 3 routes of infection in SA?
Direct infection from wound
Iatrogenic
Eruption of bone masses
What are the KEY symptoms of septic arthritis?
Hot, swollen and tender joint with systemic fever, immobility and pain is septic arthritis until proven otherwise
What are the symptoms the following groups:
Infant?
Child?
Adult
Irritable, failure to thrive, doesn’t want to move, septic
Acute pain in a single large joint, the child won’t weight bear, pyrexic and tachycardia
Single large superficial joint effected ie the knee
What is the investigations of SA?
Aspirate the joint
Culture blood
Skin cute
High leukocyte count
what is the management of sa?
Analgesics
IV benzylpenicillin and flucloxacillin 1-2 wks
Surgical drainage
Are primary bone tumours common?
No they tend to be metastases
Where are the most common metastases from?
Lung, BREAST, renal, prostate
What is the definition of a sarcoma?
This is a malignant tumour arising from the connective tissue
What Is an Osteosarcoma?
This is the most common bone malignancy in children
Are most of the tumours in bone benign or malignant?
Benign
What is the presentation of the following BENIGN bone tumours: Osteoid osteoma Osteochondroma Chondroma Giant-Cell tumour Fibroma Eosinophilic granuloma
Form bone shaft, pain at night, young adult
Cortex of long bone, painless lump, young teenager
Cartilage of hands + feet, painless, excise
Around knee, female 20-40, X-ray and excise
Asymptomatic - children under 2
Skull, 5-10yo M, removal
What are you going to examine about the lump?
Location Size Fluctuant Painful Consistency Mobility Temperature
What are the CARDINAL features of a MALIGNANT TUMOUR?
Increasing, unexplained, deep-seated dull pain Difficutly weight bearing Deep swelling Night pain Nerve patsy Activity related pain Systemic features
What are the investigations of bone tumours?
x-ray/CT/ MRI - best
May need biopsy
Full bloods
What are the features of a chondrosarcoma?
ADULTS
Dull deep pain
Mets late
wide local excision
What are the features of a osteosarcoma?
Children
Metaphyses around the knee
Pain, limp, limited ROM
Full Sx and management
What are the features of a Ewing’s sarcoma?
Tumour from mesenchymal cells
Children
Mass swelling, systemic symtoms
Chemo is first line
