Non Pyogenic Inf

Question 1

What is the mc cause of non pyogenic osteomyelitis

Answer 1

Mc cause is TB (hematogenous spread from a primary focus in lung in immunocompromised indvs)

Question 2

TB osteomyelitis timeframe

Answer 2

Tends to arise insidiously and take a chronic course (usually more slow paced progression)

Question 3

What areas is non pyogenic inf mc

Answer 3

MC involves the spine+ hip

Question 4

What can develop in the psoas due to non pyogenic osteomyelitis

Answer 4

Cold abscess (sign of old TB)

Question 5

What lab test is likely pos in Non pyogenic osteomyelitis

Answer 5

+ purified pro derivative)

Question 6

Phemisters triad (tb of peripheral jt) findings

Answer 6

• Progressive + SLOW jt space narrowing
• juxtaarticular osteoporosis
• Peripheral erosions of articular surfaces

Question 7

Features of TB arthritsis + mc loc

Answer 7

Perphers spine + hip

• long period of onset, slow
• less sclerosis
• Large dense soft tissue mass (cold abscess)

Question 8

TB Spondylitis (potts disease)- mc loc, findings

Answer 8

Common in TL region

• disk and vert body destruction resulting in Gibbus deformity (Severe scoliosis)
• Cold abscess (indicative of old infection)

Question 9

Tx of potts disease

Answer 9

Dont adjust

-refer immediatly

Question 10

Tb spondylitis vs pyogenic spondylitis (2)

Answer 10

Multiple levels of involvement in TB

relative disk sparing till later

Question 11

What are the 2 mycotic (fungal infections)

Answer 11

Coccidiomycosis

maduromycosis

Question 12

How is congenital syphilis transmitted

Answer 12

Transmitted thru placenta

Question 13

3 phases of congenital syphilis

Answer 13

1. Metaphysitis- bilateral radiolucent metaphyseal bands with saw tooth appearance
2. Periostitis- BL solid or laminated periosteal rdn
3. Osteitis- spread to diaphysis often resulting in ant bowing of tibia (sabre shin)

Question 14

2 additional features of congenital syphilis

Answer 14

Cluttons jts- BL and painless jt swelling

Hutchinsons teeth- Defomity of teeth with peg shaped/notched apperence

Question 15

When will you see skeletal changes in acquired syphilis and mc loc

Answer 15

Tertiary syphilis

-proliferative periostitis in superficial bones

Question 16

What are mycotic infections secondary to

Answer 16

primary respiratory infection or direct extension from adjacent soft tissue inf

Question 17

Coccidiodoycosis s/s

Answer 17

may mimic tb (lungs first than other organ systems)

• Self limiting
• focal lytic defects some soft tissue involvement (need hx)

Question 18

Maduromycosis- mc affected location, where in world, how does it occur

Answer 18

• primarily affects feet from adjacent soft tissue inf
• MC in tropical regions
• Mc fungal infection world wide

Question 19

Presentation of necrotizing inf

Answer 19

Air lucencies within soft tissue (can lead to compartment syndrome)