infections of bones and joints

Question 1

infectious arthritis

Answer 1

bacterial arthritis: local response w/ joint destruction and sepsis

S. aureus and Neisseria gonorrhoeae are the most common organisms responsible for infectious arthritis

any joint that is infected is considered a medical emergency

Question 2

what erodes the articular cartilage in infection arthritis

Answer 2

PANNUS

erode articular cartilage of the joint capsule and subchondral bone

Question 3

what is the difference b/w arthritis and infectious arthritis

Answer 3

infectious arthritis has a rapid onset

17 days

Question 4

infectious arthritis diagnosis

Answer 4

analysis of joint fluid obtained by aspiration to identify bacterial agent

Question 5

clinical manifestation of infectious arthritis

Answer 5

classic signs

increased temp of joint

swelling

redness

loss of function***

Question 6

osteomyelitis

Answer 6

Inflammation of bone caused by an infectious organism such as bacteria, but fungi, parasites, and viruses can also cause skeletal infections

Question 7

causative agent of acute osteomyelitis

Answer 7

Staphylococcus aureus

in pts w/ sickle cell –> salmonella

Question 8

etiology of osteomyelitis

Answer 8

Can be acquired from exogenous (external) or hematogenous (blood) sources

Exogenous osteomyelitis is acquired by invasion of the bone by direct extension from the outside as a result of inoculation into the bone (i.e. compound fractures)

Hematogenous osteomyelitis is acquired from spread of organisms from preexisting infections

Question 9

where does osteomyelitis usually develop

Answer 9

metaphysis (transitional part between the shaft and the end) of long bones

The porous nature of the metaphysis allows the organisms to grow and spread through the bone

Question 10

clinical manifestations of osteomyelitis

Answer 10

*Any unexplained cellulitis should be considered a sign of osteomyelitis in children as well as high fever and intense pain

back pain

Question 11

gout

Answer 11

“rich man’s disease”

caused by elevated serum uric acids and the deposition of urate crystals primarily in the big toe, ankle, instep, wrist, elbow, and fingers which trigger an inflammatory response necrosis and fibrosis

heavy alcohol consumption and high protein intake can trigger symptoms

Question 12

triad for gout

Answer 12

monoarticular arthritis

hyperuricemia

prompt response to drug therapy (NSAIDs)

Question 13

gout treatment

Answer 13

aloopurinol

prevent/lessen future attack by slowing rate of body making uric acid

key treatment

Question 14

CPPD

Answer 14

calcium pyrophosphate dihydrate crystals

pseudogout or chondrocalcinosis

presence of calcium pyrophosphate dihydrate crystals in synovial fluid

symptoms identical to gout

more common in women and have polyarticular involvement primarily in the knees

Question 15

symptoms of gout and CPPD

Answer 15

acute mono-articular inflammatory arthritis –> joint pain at night

erythema

warmth

tenderness

hypersensitivity

chills

fever

tachycardia