Chronic Osteomyelitis

Question 1

Etiology

Answer 1

1. Open fracture
2. Surgery
3. Inadequate acute osteomyelitis treatment

Question 2

Causal Organism

Answer 2

• staph aureus (commonest)
• implant (staph epidemidis)
• mixed growth (pseudomonas, proteus)
• contaminated wound (anaerobes such as bacteroides, clostridium)

Question 3

Risk Factors

Answer 3

1. history of trauma
2. smoker
3. malnutrition
4. substance abuse
5. diabetes mellitus

Question 4

Clinical Features

Answer 4

1. Fever
2. Pain
3. Swelling
4. Seropurulent discharge

Question 5

ix

Answer 5

1. fbc
2. esr
3. crp

• to assess progresss
  4. culture sensitivity or pcr (rarely)

5

Question 6

x-ray

Answer 6

1. cloaca (discharge) mcm sinus

2. sequesterum (dead bone)

Question 7

staging

Answer 7

anatomical
I- medullary
II- superficial
III- localised
IV- diffised 

host background

Question 8

cx

Answer 8

1. septic arthritis

2. malignant transformation

Question 9

tx

Answer 9

1. abx
   - non-toxic long term use
   - penetrates sclerotic bone

fusidic, clinda, cephalo
mrsa? vanco

2. local
   - local (dressing, i and d)
   -

3, operation
(Wd, removal of implant)

4. aftercare
   - education hygiense