Infection - Osteomyelitis

Question 1

What is responsible for around 90% of all bone and joint infections?

Answer 1

Staphylococcus

Question 2

What are the 4 major pathways of spread of suppurative Osteomyelitis?

Answer 2

Hematogenous
Spread from contiguous source of infection
Direct implantation
Postoperative infection (iatrogenic)

Question 3

What is the most common source of Osteomyelitis and is involved with UTIs and Respiratory infections?

Answer 3

Hematogenous Spread

Question 4

What age and gender is most susceptible to suppurative osteomyelitis?

Answer 4

2-12 year old males

Question 5

What type of bones does suppurative osteomyelitis affect?

Answer 5

large tubular bones

Question 6

What makes the radiologic and pathologic features of osteomyelitis differ in the infant, child, and adult?

Answer 6

blood supply of growth centers

Question 7

What does periosteal and subperiosteal area results in?

Answer 7

necrosis of cortex

Question 8

What do Cortical and medullary infarcts result in?

Answer 8

Sequestrum

Question 9

What is a significant radiographic feature of infection of the periosteum due to infection and pus in the bone causing new bone formation?

Answer 9

involucrum

Question 10

What is a defect in the involucrum known as?

Answer 10

Cloaca

Question 11

What is a cloaca commonly associated with?

Answer 11

Chronic Osteomyelitis

Question 12

What is a malignant degeneration of a chronic wound or scar that is commonly seen in squamous cell carcinoma?

Answer 12

Marjolin Ulcer

Question 13

What imaging should you order when you suspect infection?

Answer 13

MRI with and without Gadollinum contrast

Question 14

What percentage of infections involve extremities? Spine?

Answer 14

Extremities: 90%
Spine: 10%

Question 15

If infection affects the spine, what part of the spine is most commonly affected?

Answer 15

Lumbar Spine

Question 16

What age is mostly predisposed to spinal infection?

Answer 16

<20 year olds

Question 17

What does Adult Spondylitis infection most commonly affect in the spine?

Answer 17

anterior vertebral endplate

Question 18

What part of the spine will you see widening of retropharyngeal and retrotracheal spaces?

Answer 18

Cervical spine

Question 19

What part of the spine will you see displacement of paraspinal lines?

Answer 19

thoracic spine

Question 20

What part of the spine will you see paravertebral or psoas abscesses?

Answer 20

Lumbar spine

Question 21

What is a localized aborted form of suppurative osteomyelitis that is associated with nocturnal limb pain that is relieved by aspirin?

Answer 21

Brodie’s Abscess

Question 22

Who does Brodie’s abscesses most commonly affect?

Answer 22

male children

Question 23

Where in the body does Brodie’s abscess most commonly appear at?

Answer 23

Distal and proximal tibia

Question 24

What bacteria is most commonly associated with Brodie’s abscess?

Answer 24

Staphylococcus aureus

Question 25

What bacteria is most commonly associated with Chronic Osteomyelitis?

Answer 25

Staphylococcus aureus

Question 26

In regards to TB, infection of the musculoskeletal system is commonly caused by what?

Answer 26

hematogenous spread of primary pulmonary focus

Question 27

What is a common characteristic symptom of TB?

Answer 27

Pott’s Paraplegia: sudden onset of lower limb paraplegia | Pott's Disease

Question 28

What age does non-suppurative osteomyelitis of TB affect?

Answer 28

<5yo

Question 29

What is the key characteristic with Pott's disease?

Answer 29

erosion of anterior vertebral body endplate

Question 30

How does TB and Pott's disease spread in the spine?

Answer 30

Batson's plexus

Question 31

What part of the spine does Pott's disease in regards to TB most commonly seen? What specific level?

Answer 31

lower thoracic and upper lumbar spine | MC: L1

Question 32

What type of deformity can Pott's disease lead to in children?

Answer 32

Gibbus Deformity

Question 33

What part of the body does Tubercular arthritis most commonly affect?

Answer 33

hip and knee

Question 34

Where does Tubercular arthritis begin and spread to?

Answer 34

Metaphysis to adjacent joint

Question 35

What type of radiographic lesion is associated with Tubercular arthritis?

Answer 35

Moth-eaten lesion

Question 36

What is the end-stage of Pott's disease?

Answer 36

fibrous ankylosis of joint

Question 37

What is another name for Pott's Disease?

Answer 37

Tubercular spondylitis

Question 38

Does Pott's disease usually affect unilateral or bilateral SI joints?

Answer 38

Unilateral

Question 39

What is a key radiographic feature of Tuberculous Dactylitis?

Answer 39

spina ventosa