Bones and Joints Flashcards
Acute osteomyelitis MC seen in ___
Chronic osteomyelitis MC seen in ___
MC organism in osteomyelitis
Acute osteomyelitis MC seen in CHILDREN
Chronic osteomyelitis MC seen in ADULTS
Staph. Aureus
Salmonella* osteomyelitis seen in ____
Tx:
Sickle cell disease
Tx: 3rd gen ceph (Cipro) OR Flouroquinolone (Levofloxacin)
- Most sensitive test in early osteomyelitis
2. Gold standard in dx of osteomyelitis
- MRI
2. Bone Aspiration
- Tx of acute osteomyelitis
2. Tx of chronic osteomyelitis
- IV abx for 4-6 weeks; 6-8 weeks overall of abx
2. 4 weeks - 24 months of IV and PO abx
Tx of acute osteomyelitis from puncture wound
MC organism:
Cipro* or Levofloxacin
Pseudomonas
Tx of acute osteomyelitis w/
- Methicillin sensitive
- Methicillin Resistant
- Nafcillin OR Oxacillin;
PCN allergy –> Clindamycin or Vancomycin - Vancomycin
Osteosarcoma MC in ____
Occur in ____ bones
MC metastasize to ___
X ray shows ____
Adolescents (<20 y/o), 2nd peak in 50-60 y/o
Metaphysis of long bones ( MC in femur*, tibia, humerus)
Metastasize to lung
“hair on end”, “sun ray/burst”
Codman’s triangle
Ewing’s Sarcoma MC in ____
Occur in ____ bones
X ray shows ____
Children, Males 5-25 y/o
Diaphysis of long bones, ribs, flat bones (MC in femur, pelvis)
“Onion peel” = lytic lesion w/ layered periosteal reaction
Chondrosarcoma MC in ___
X ray shows ___
Adults (40-75 y/o)
3rd MC primary malignancy of bone
Matrix punctate or ring and arch appearance pattern of calcifation
Osteochondroma MC in ___
Diagnosis:
Tx:
MC benign bone tumor
Males, 10-20 y/o
Pedunculated, grows away from growth plate*, involves medullary tissue
Observation. Resection if painful, located in pelvis
Intracompartmental pressure of _____ is diagnosis of Compartment syndrome
> 30-45 mm Hg
Primary osteoporosis Type I associated with ____ .
____ bone affected.
MC fracture sites (3)
loss of estrogen in postmenopausal women, testosteron deficiency in men
Trabecular bone
Vertebrae, hip, distal radius
Primary osteoporosis Type II associated with ____.
____bone affected.
MC fracture sites (2)
> 75 y/o w/ poor calcium absorption
Trabecular and cortical bone
Hip, pelvis
Screening DEXA scan recommended for:
Postmenopausal women >65 y/o
Postmenopausal women <65 y/o w/ 1 or more additional RF
RF: alcohol, smoking, low body weight, sedentary, low calcium and vit D intake, corticosteroid use, recurrent falls
Advanced age, Caucasian/Asian, female
1st line treatment of osteoporosis
How should it be taken?
Long term use complications
Bisphosphonate
On empty stomach, sit upright for 30-60 min after ingestion
Weakened bones, Jaw necrosis –> monitor closely
MC wrist injury MOI: Diagnosis: Complication: Tx:
Colles Fracture
MOI: FOOSH –> extension fracture –> dorsal displacement of bone fragment
Diagnosis: “dinner fork deformity”
Complication: Extensor pollicus longus tendon rupture
Tx: Sugar tong splint/cast
Smith fracture =
Diagnosis:
Flexion fracture –> volar displacement of bone fragment
Dx: Garden Spade Deformity
Radial nerve injury causes
wrist drop
Colles and Smith fracture may cause injury to ___ nerve, ___ artery
Median nerve, radial artery
Median nerve injury causes
Inability of thumb opposition
Numbness/tingling in thumb and 2nd,3rd and 1/2 4th digit
Study of choice to diagnose occult hip fracture
MRi
IV abx of choice for open fractures
1st and 2nd gen cephalosporins
aminoglycosides
48 hrs after fracture, 48 hrs after surgical procedures
Salter Harris Classification
Straight through epiphyseal plate = Type 1
Above epiphyseal plate, involve metaphyseal fragment = Type 2
Lower/beLow, through epiphysis into articular surface = Type 3
Through distal metaphysis, epiphyseal plate and epiphysis = Type 4
c(E)Rush of epiphyseal plate = Type 5
Lisfranc fracture
dislocation of tarsometatarsal joint complex
