Musculoskeletal Infections Flashcards
where will you see HOM in children
Metaphyseal bone (growth plates)
where will you see HOM in adults
vertebral bodies
- septic joints
Why is HOM in metaphyses in children?
metaphyseal blood flow slows down in the hair pin turns —> bony infection
What are the down stream effects of infection?
increase bone resorption
increased pus in bone–> spreads to joint—> septic joint
can children get joint infections?
yes
what location can go from osteomyelitis to septic joints in children?
ankle, elbow, shoulder, hip
how will xrays show bone infection?
Lucency
might take 1-2 weeks to show changes — 30-40% loss needed to show
Treatment for HOM?
Antibiotics - 4 to 6 weeks
I and D
Debridement
Bacteria found in native joints?
Coag positive staph (aureus)
Bacteria found in implants?
coag neg. staph (s. epi)
Bacteria in sickle cells patients?
salmonella
What does chronic OM look like?
Bone within a bone…sequestration
What can happen in C OM?
Sinus tract formation– chronic wound —-> Squamous cell carcinoma (aggressive)
very difficult to eradicate
Treatment for COM?
antibiotic for organism
remove sequestration
GIVE BLOOD
Commons sites for infectious arthritis in kids
Hip and Knees
Sternoclavicular Joint - IV drug users
Most common cause infectious arthritis?
Hematogenous spread
why is IA in a children dangerous
can lead to chondrocyte death with limited capacity for repair
How to make diagnosis for inflamed joint?
palpate for effusion
joint aspiration
cell count
gram stain
crystal analysis
what causes inflamed joint?
infections, autoimmune, trauma, arthritis.
What will joint aspirate look like for inf. arthritis?
WBC>50,000
High % neutrophils (90%)
What can infectious arthritis lead to?
osteomyelitis and growth disturbance
why type of joint can get a glycocalyx?
a prosthetic joint — can lead to biofilm
What bacteria infects shoulder replacements?
P. Acnes
How to diagnoses prosthetic joint infection
aspiration
WBC>1100
Neutrophils> 64%
