CHRONIC OSTEOMYELITIS

Question 1

ETIOLOGY

Answer 1

STAPH AUREUS
E COLI

Question 2

CLINICAL FEATURES

Answer 2

CHR ONIC DISCHARGING SINUS
REPEATED FLARES OF FEVER, REDNESS AND TENDERNESS
SINUS FIXED TO UNDERLYING BONE
SURROUNDING SKIN MAY BE PUCKERED UP DUE TO PREVIOUSLY HEALED SINUS

Question 3

IMAGING

Answer 3

X RAY
SINOGRAM
CT / MRI
BONE SCAN

Question 4

X RAY

Answer 4

THICKENED AND IRREGULAR CORTEX
PATCHY SCLEROSIS
SEQUESTRUM
INVOLUCRUM
CLOACAE

Question 5

SINOGRAM

Answer 5

SHOWS ORIGIN OF PUS

Question 6

TREATMENT

Answer 6

SURGERY IS CHOICE
ANTIBIOTICS - FUSIDIC ACID , CLINDAMYCIN, CEPHALOSPORIN USED AS THEY CAN PENETRATE SCLEROTIC BONE
ANTBIOTICS GIVEN BEFORE SURGERY FOR 4 TO 6 WEEKS

Question 6

BLOOD INVESTIGATION

Answer 6

CBC- NORMAL
EXAMINATION OF PUS

Question 7

SURGERY

Answer 7

DEBRIDEMENT - @ ACESS
AMPUTATION
CURETTAGE
EXCISION
SAUCERISATION
SEQUESTROMY

OBLITERATION OF DEAD SPACE

Question 8

COMPLICATIONS

Answer 8

REPEATED INFECTION
GROWTH ABNORMALITIES-
SHORTENING , LENGTHENING, DEFORMITY
PATHOLOGICAL FRACTURE
JOINT STIFFNESS
SINUS TRACT MALIGNANCY