Infectious Diseases of MSK Flashcards
define osteomyelitis
an infection of bone marrow that can spread to the bone cortex
common causes of osteomyelitis
staph aureus
coagulase-negative staphylococci
haemophilus influenzae
escherichia coli
categories of osteomyelitis
haematogenous
- results from haematological bacteria seeding from remote source
- more common in children
contiguous:
- occurs when direct contact between infected tissue and bone
risk factors of osteomyelitis
immunosuppression trauma prosthetic ortho device diabetes extremes of age
clinical features of acute osteomyelitis in infants
septic appearance failure to thrive drowsy and irritable metaphyseal swelling and tenderness ⬇️ ROM
clinical features of acute osteomyelitis in children
severe pain of affected area ⬇️ ROM and movement reluctancy swinging pyrexia tachycardia malaise
clinical features of chronic osteomyelitis
previous acute infection
swelling
⬇️ ROM
chronic fatigue
gold standard investigation in osteomyelitis
bone biopsy
additional investigations in osteomyelitis
bloods (FBC, ESR, CRP, U+Es and cultures)
XR
MRI
aspirate
management of acute osteomyelitis
analgesics
IV fluids
4-6wk course flucloxacillin and rifampicin (start IV and switch to oral)
rest and splint affected site
indications for surgery in osteomyelitis
pus present
infected, dead or contaminated tissue
no response to antibiotics
infected joint prosthetic
management of chronic osteomyelitis
surgical debridement
long-term antibiotics
amputation
blood test result used to track treatment efficacy in osteomyelitis
erythrocyte sedimentation rate (ESR)
define septic arthritis
infection of the joint caused by either bacteria or a virus that spreads to the fluid surrounding the joint
causative organisms in septic arthritis
staph aureus
haemophilus influenza
strep pyogenes
e.coli
risk factors of septic arthritis
joint disease
chronic kidney disease
immunosuppression
prosthetic joints
clinical features of septic arthritis
acutely inflamed tender and swollen joint
⬇️ ROM
systemically unwell
investigations of septic arthritis
joint aspirate for MCS bloods tests (FBC, ESR or CRP) blood cultures XR joint
management of septic arthritis
IV antibiotics (flucloxacillin IV for 2wks then oral 2-4wks) splinting of the limb supportive measures
management of septic arthritis if no response to antibiotics
joint drainage and lavage
< wash out to remove infected tissue and pus
< only used if temperature fails to settle
