Musculoskeletal Infections

Question 1

where will you see HOM in children

Answer 1

Metaphyseal bone (growth plates)

Question 2

where will you see HOM in adults

Answer 2

vertebral bodies

- septic joints

Question 3

Why is HOM in metaphyses in children?

Answer 3

metaphyseal blood flow slows down in the hair pin turns —> bony infection

Question 4

What are the down stream effects of infection?

Answer 4

increase bone resorption

increased pus in bone–> spreads to joint—> septic joint

Question 5

can children get joint infections?

Answer 5

yes

Question 6

what location can go from osteomyelitis to septic joints in children?

Answer 6

ankle, elbow, shoulder, hip

Question 7

how will xrays show bone infection?

Answer 7

Lucency

might take 1-2 weeks to show changes — 30-40% loss needed to show

Question 8

Treatment for HOM?

Answer 8

Antibiotics - 4 to 6 weeks

I and D

Debridement

Question 9

Bacteria found in native joints?

Answer 9

Coag positive staph (aureus)

Question 10

Bacteria found in implants?

Answer 10

coag neg. staph (s. epi)

Question 11

Bacteria in sickle cells patients?

Answer 11

salmonella

Question 12

What does chronic OM look like?

Answer 12

Bone within a bone…sequestration

Question 13

What can happen in C OM?

Answer 13

Sinus tract formation– chronic wound —-> Squamous cell carcinoma (aggressive)

very difficult to eradicate

Question 14

Treatment for COM?

Answer 14

antibiotic for organism

remove sequestration

GIVE BLOOD

Question 15

Commons sites for infectious arthritis in kids

Answer 15

Hip and Knees

Sternoclavicular Joint - IV drug users

Question 16

Most common cause infectious arthritis?

Answer 16

Hematogenous spread

Question 17

why is IA in a children dangerous

Answer 17

can lead to chondrocyte death with limited capacity for repair

Question 18

How to make diagnosis for inflamed joint?

Answer 18

palpate for effusion

joint aspiration
cell count
gram stain
crystal analysis

Question 19

what causes inflamed joint?

Answer 19

infections, autoimmune, trauma, arthritis.

Question 20

What will joint aspirate look like for inf. arthritis?

Answer 20

WBC>50,000

High % neutrophils (90%)

Question 21

What can infectious arthritis lead to?

Answer 21

osteomyelitis and growth disturbance

Question 22

why type of joint can get a glycocalyx?

Answer 22

a prosthetic joint — can lead to biofilm

Question 23

What bacteria infects shoulder replacements?

Answer 23

P. Acnes

Question 24

How to diagnoses prosthetic joint infection

Answer 24

aspiration

WBC>1100
Neutrophils> 64%