Infections Flashcards
What does the “CATBITES” acronym stand for?
Congenital, Arthritis, Trauma, Blood, Infection, Tumor, Endocrine/Nutritional/Metabolic, Soft Tissue
What are the 4 major “S” joints affected with infection in drug addicts?
Spine, Sacroiliacs, Symphysis Pubis, Sternoclavicular
What is the most common organism to cause musculoskeletal infections?
Staphylococcus aureus (90%)
What is the most common route of dissemination for a musculoskeletal infection?
Hematogenous
Which population tends to have a more acute process of symptomatology with a musculoskeletal infection: infants/young adults or older adults?
Infants/young adults (fever, chills, pain, swelling, loss of limb function, elevated ESR, elevated white count with a shift to the left)
Which population tends to have a more insidious process of symptomatology with a musculoskeletal infection: infants/young adults or older adults?
Older adults (fever, malaise, edema, erythema, pain)
In 50% of musculoskeletal infection cases, there tends to be a preexisting infection in which organs?
Skin, respiratory tract, genitourinary tract
What is the most common age range and gender bias for suppurative osteomyelitis?
Males 2-12 years old
Which pattern tends to spare the epiphysis and joint: infantile, childhood, or adult?
Childhood (because the growth plates have not yet ossified)
What is the most common location for a musculoskeletal infection?
KNEE (then hip, ankle, shoulder, spine)
What are the two main categories of musculoskeletal infections?
Suppurative (OM) or non-suppurative (TB)
What kind of infection is suppurative osteomyelitis?
Bone marrow infection by (pyogenic) non-tubercular organism (aka anything but TB)
What is the most likely agent involved with OM?
Staph. aureus (could also be Step. pneumoniae, E. coli, or pseudomonas)
What are the four radiographic stages of a musculoskeletal infection?
1 latent/hidden (1-10 days), 2 early (10-21 days), 3 middle (weeks), 4 (months)
What are the radiographic signs of the early stage?
Soft tissue edema and swelling, osteopenia
What is the best way to differentiate between gout or infection?
AGE (gout is highly unlikely in children) but also time…gout takes year, infection is quick and acute
Moth eaten or permeative destruction is seen in which radiographic stage of a musculoskeletal infection?
Middle (along with periosteal responses)
What is the best way to differentiate between an infection or bone cancer when periosteal reactions are present?
Infection presents with FEVER
What is the best way to differentiate between a geographic infection or something like a simple bone cyst?
Infection will be accompanied with PAIN
Involucrum, sequestrum, and cloaca are seen in which radiographic stage?
Late
What is the term for the chalky, white area representing isolated dead bone in the infection?
Sequestrum
What is the term for the “bony collar” and chronic periosteal response where the pus lifts the periosteum and causes new bone formation in an attempt to wall off the infection?
Involucrum
What is the term for the opening of the involucrum that allows for drainage of necrotic and purulent material from the dead bone?
Cloaca
What can happen to the cloaca if left untreated?
Can turn into squamous cell carincoma
Brodie’s abscess formation is similar to what other bone condition?
Osteoid osteoma
In what way is Brodie’s abscess formation similar to an osteoid oteoma?
Similar in appearance but also has localized pain that is worse at night and relieved by aspirin
What condition is a localized, aborted form of suppurative osteomyelitis that can even be sterile with no infectious organism that also mimics an osteoid osteoma?
Brodie’s abscess formation
What is the most common location for a Brodie’s abscess formation?
Metaphysis, distal tibia