Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Lecture 4 Infection in Bone and Joints > Flashcards

Lecture 4 Infection in Bone and Joints Flashcards

1
Q

What group of people are more prone to osteomyelitis

A

Boys

Children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the risk factors for osteomyelitis

A 
DM
Rheumatoid arthritis
Immune compromise
Long term steroid use
Sickle cell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the sources of infection for osteomyelitis in children and elderly

A

Haematogenous- children and elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the sources of infection for osteomyelitis in trauma

A 
•	Local spread from contiguous site of infection
o	Trauma (open fracture)
o	Bone surgery
o	Joint replacement
•	Secondary to vascular insufficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the sources of infection for osteomyelitis in infants

A

Infected umbilical cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the sources of infection for osteomyelitis in children

A

Boils
Tonsilitis
Skin abrasions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the sources of infection for osteomyelitis in adults

A

UTI

Arterial line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name 3 common organisms that affect infants <1 who have osteomyelitis

A

o Staph aureus
o Group B streptococci
o E. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name 3 common organisms that affect older children who have osteomyelitis

A

o Staph aureus
o Strep pyogenes
o Haemophilus influenza- immunisation significantly reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name 3 common organisms that affect adults who have osteomyelitis

A 
o	Staph aureus
o	Pseudomonas aeruginosa
-	Immunocompromised
-	Trainer’s foot- penetrating foot injuries
-	IVD
o	Coagulase negative staphylococci
-	Prostheses 
o	Propionibacterium spp.
-	Shoulder replacements
-	Prostheses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What organism causes osteomyelitis in diabetic foot and pressure sores

A

Mixed infection including anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What organism causes osteomyelitis in vertebral osteomyelitis

A

Staph aureus

TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What organism causes osteomyelitis is Sickle Cell Disease

A

Salmonella spp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Candida causes osteomyelitis in what groups of people

A

HIV/AIDs
Long term antibiotic treatment
Extensive GI surgery
Malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What part of the bone does osteomyelitis start

A

Metaphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the clinical features of osteomyelitis in an infant

A
  • Failure to thrive
  • Drowsy or irritable
  • Metaphyseal tenderness and swelling
  • Decrease ROM
  • Positional change- may be flexed
  • Commonest around the knee
  • Often multiple sites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the clinical features of osteomyelitis in children

A
  • Severe pain
  • Reluctant to move
  • Fever (swinging pyrexia) + tachycardia
  • Malaise (fatigue, nausea, vomiting, fretful)
  • Toxaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the clinical features of osteomyelitis in adults

A

Backache
History of UTI or urological procedure
Often after open fracture

19
Q

How is osteomyelitis diagnosed

A 
History and clinical examination
FBC and WBC (neutrophil leucocytosis)
Blood culture
U&amp;Es
X-Ray
US
Aspiration
Isotope bone scan
Labelled white cell scan
MRI
20
Q

What are the differential diagnosis of osteomyelitis

A
  • Acute septic arthritis
  • Trauma (fracture, dislocation)
  • Acute inflammatory arthritis
  • Transient synovitis (irritable hip)
21
Q

What is the treatment of osteomyelitis

A

Supportive
Rest and splintage
Antibiotics
Surgery (debridement, drainage, infected joint replacements)

22
Q

Name complications of osteomyelitis

A
  • Metastatic infection
  • Pathological fracture
  • Septic arthritis
  • Septicaemia, death
  • Altered bone growth
  • Chronic osteomyelitis
23
Q

Name the causes of Chronic Osteomyelitis

A 
Follow acute osteomyelitis
De novo
o	Following operation
o	Following open fractures
o	Immunosuppressed, diabetics, elderly, drug abusers
24
Q

Name common organisms that cause osteomyelitis

A 
Often mixed
Staph aureus
E.coli
Strep pyogenes
Proteus
25
Q

What is the pathology of chronic osteomyelitis

A

Cavities, possibly sinuses
Dead bone
Involucrum

26
Q

How is chronic osteomyelitis treated

A 
Long term antibiotics 
Local- gentamicin
Systemic
Surgical
Deformity correction
Amputation
27
Q

Complications of chronic osteomyelitis

A
  • Chronically discharging sinus and flareups
  • Ongoing (metastatic) infection (abscesses)
  • Pathological fracture- never heal
  • Growth disturbance (deformities)- damage of growth plate
  • SCC
28
Q

Name the routes of infection of Septic arthritis

A

Haematgenous
Eruption of bone abscess
Direct invasion

29
Q

Organisms responsible for septic arthritis

A
  • Staph aureus
  • Haemophilus influenzae
  • Strep pyogenes
  • E. coli- neonates or very old
30
Q

What are the clinical presentation of septic arthritis in neonates

A
  • Picture of septicaemia
  • Irritability
  • Resistant to movement
31
Q

What are the clinical presentation of septic arthritis in child and adults

A
  • Reluctant to move the joint
  • Swelling-seen in superficial joint
  • Not erythema- unless superficial and later
  • Increase temp. and pulse
32
Q

What are the clinical presentation of septic arthritis in adults

A
  • Increase tenderness
  • Often involves superficial joint (knee, ankle, wrist)
  • Rare in healthy adult
  • May be delayed diagnosis
33
Q

How is septic arthritis diagnosed

A
  • FBC, WBC, ESR, CRP, blood cultures
  • X ray
  • Ultrasound
  • MRI
  • Aspiration
34
Q

What is the most common cause of septic arthritis

A

Infected joint replacement

35
Q

Differential diagnosis of septic arthritis

A
  • Acute osteomyelitis
  • Trauma
  • Irritable joint
  • Haemophilia
  • Rheumatic fever
  • Gout
  • Gaucher’s disease
36
Q

How is septic arthritis treated

A

Supportive
Antibitiotics (3-4 weeks)
Surgical drainage and lavage
Infected joint replacements

37
Q

What are the classifications of tuberculosis bone infection

A

Extra articular
Intra articular
Vertebral body

38
Q

What are the clinical features of a tuberculosis bone infection

A
  • Pain (especially at night), swelling, weight loss (confused with bone tumours)
  • Low grade pyrexia
  • Joint swelling
  • Decrease ROM
  • Ankylosis
  • Deformity
39
Q

What is the commonest TB bone infection

A

Spinal TB

40
Q

What are the clinical features of Spinal YB

A

Little pain

Abscess or kyphosis

41
Q

What are the investigations for TB bone infections

A
  • FBC, ESR
  • Mantoux test
  • Sputum/urine culture
  • X-ray
  • Joint aspiration and biopsy
42
Q

What is the differential diagnosis of TB bone infection

A
  • Transient synovitis
  • Monoarticular RA
  • Haemorrhagic arthritis
  • Pyogenic arthritis
43
Q

What is the treatment for a TB bone infection

A

• Chemotherapy initially for 8 weeks:
o Rifampicin
o Isoniazid
o Ethambutol
• Then rifampicin and isoniazid 6-12 months
• Rest and splintage
• Operative drainage/fusion rarely necessary

MSK (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions