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Dx Imaging II > Musculoskeletal Infections > Flashcards

Musculoskeletal Infections Flashcards

1
Q

infection of skin, subcutaneous, fat, or connective tissue (soft tissue infection)

A

cellulitis

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2
Q

infection of bone (marrow spaces)

A

osteomyelitis

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3
Q

infection of joint (synovial tissue, articular surfaces)

A

septic arthritis

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4
Q

group of people prone to infections by unusual organisms at unusual sites

A

drug addicts

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5
Q

MC organism for musculoskeletal infections*

A

staph. aureus

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6
Q

MC route of dissemination for musculoskeletal infections

A

hematogenous

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7
Q

growth plates inhibit ONLY this route of dissemination

A

hematogenous

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8
Q

MC locations for musculoskeletal infections (KHASS)

A
  • knee
  • hip
  • ankle (distal tibia)
  • shoulder
  • spine
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9
Q

two major categories of musculoskeletal infection

A
  1. suppurative (pus, staph)

2. non-suppurative (Tb)

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10
Q

bone marrow infection by pyogenic non-TB organism

A

suppurative osteomyelitis

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11
Q

clinical features of acute infection

A 
1 edema
2 lymphadenopathy
3 warm skin
4 cellulitis
5 joint pain
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12
Q

4 radiographic stages of infection

A
  1. latent stage (1-10 days)
  2. early stage (days 10-21)
  3. middle stage (weeks)
  4. late stage (months)
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13
Q

symptoms of early stage infection

A
  • spinal lesion
  • ST swelling
  • displaced lucent fat planes become mass like
  • osteopenia
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14
Q

characteristics of middle stage infection

A

permeative or lytic moth-eaten destruction and periosteal response; solid, laminated, codman’s trianlge

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15
Q

characteristics of late stage infection

A
  • cortical destruction
  • draining sinus
  • involucrum
  • cloaca
  • sequestrum
  • sclerosis
  • debris
  • loss of joint space
  • ankylosis
  • chronic incomplete resolution
  • immune deficient
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16
Q

chalky, white area representing isolated dead bone; cortical and medullar infarcts

A

sequestrum

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17
Q

chronic periosteal response. pus lifts the periosteum and causes new one formation that tries to wall off the infection.

A

involocrum

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18
Q

bony collar

A

involocrum

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19
Q

draining sinus, more common with chronic disease

A

cloaca

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20
Q

a rare complication of cloaca is to develop a squamous cell carcinoma with malignant transformation has been called

A

marjolin’s ulcer

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21
Q

localized, aborted form of suppurative osteomyelitis that has localized pain worse at night and relived by aspirin

A

brodie’s abscess formation

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22
Q

oval, elliptical or serpiginous radiolucency surrounded by reactive sclerosis mimics osteoid osteoma. located in distal tibia.

A

brodie’s abcess

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23
Q

seen in chronic osteomyelitis and reactive sclerosis

A

brodie’s abcess

24
Q

prognosis of infection

A
  • better detection and tx today

- require antibiotic mgmnt

25
Q

infection of vertebral body

A

spondylitis

26
Q

tear drop distance normally

A

9 - 11 mm

27
Q

early radiographic features of spine infection

A
  • rapid loss in disc space
  • endplate destruction
  • pre-vertebral ST swelling
28
Q

upper limit size of the retro-tracheal interspace (RTI)

A

22mm

29
Q

upper limit size of the retro-pharyngeal interspace (RPI)

A

7mm

30
Q

water is white on which film

A

T2 weighted MRI

31
Q

fat is white on which flim

A

T1 weighted MRI

32
Q

MC cause of suppurative osteomyelitis

A

staph. aureus

33
Q

both infections and tumors respect epiphyseal growth plates

A

FALSE: tumors respect the boundary but infections do not

34
Q

disc space loss with endplate destruction is a classic example of

A

spine infection

35
Q

risk groups for bone infection

A
  • immunosupressed
  • diabetic
  • post surgical
  • vascular insufficiency
  • sickle celll anemia
  • IV drug users
36
Q

some organisms that cause bone infection and MC

A
  • STAPH. AUREUS (90%)
  • mycobacterium TB
  • neisseria gonorrhea
  • pseudomonas
  • fungus
  • strep. pyogenes
37
Q

modes of infection

A
  • trauma/post surgical
  • UTI
  • pneumonia
  • skin infections
  • open wound or cellulitis
  • heel sticks in infants
38
Q

routes of dissemination for bone infection

A
  • HEMATOGENOUS (MC)
  • direct extension
  • direct implantation
  • postoperative
39
Q

growth plates inhibit which type of dissemination/spread

A

hematogenous; children affected less than adults or infants

40
Q

study done sensitive to metabolic activity and increased vascular supply

A

bone scan

41
Q

most important dx to consider when patient presents with unilateral sacroilitis

A

infection

42
Q

exam needed if loss in disc space and endplate destruction

A

think infection so; MRI

43
Q

osteomyelitis findings on an MRI

A
  • decreased signal intensity T1

- increased signal intensity T2

44
Q

*MC cause of infection-related death world wide “king of disease”

A

TB

45
Q

MC type of TB

A

secondary form of Tb

46
Q

MC location of TB in the spine

A

Spine TL junction

47
Q

first radiographic finding of TB in an adult

A

earliest - anterior disc space narrowing.

48
Q

phemster’s triad indicative of

A

TB septic arthritis

49
Q

phemster’s triad (JaMS)

A
  • juxtarticular osteoporosis
  • marginal erosions
  • slow joint space loss
50
Q

type of TB found in spine, involving multiple levels with paraspinal cold abcesses, slower progression of jt destruction, poorer response to therapy

A

non-suppurative; as opposed to suppurative

51
Q

destructive changes of EPs and bodies w acute kyphotic angulation

A

gibbus formation

52
Q

TB associated with the spine

A

pott’s disease

53
Q

Clinical findings associated with Tb

A
  • positive Tb skin test 90-100%
  • chest film (+) for granulomas in 50%
  • wt loss, fever, chills, night sweats, tenderness in involved bones and jts
54
Q

Radiographic findings of Tb similar to suppurative BUT…

A
  • multiple level paraspinal cold abscesses w Ca (parallel psoas major m.)
  • adult infxn typically starts in anterior endplate region
  • disc space narrowing earliest radiographic finding
  • vertebral collapse
  • decreased T1, increased T2
  • much slower and indolent
55
Q

joint space loss and lytic destruction that crosses joint space indicate

A

septic arthritis

Dx Imaging II (5 decks)

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