Ortho - Osteomyelitis

Question 1

What is osteomyelitis?

Answer 1

Infection in the bone and bone marrow causing inflammation

Question 2

Where does osteomyelitis typically occur?

Answer 2

Metaphysis of the long bones

Question 3

What is the most common cause of osteomyelitis?

Answer 3

Staphylococcus aureus

Question 4

How does osteomyelitis occur?

Answer 4

Haematogenous spread
Direct introduction by open fracture

Question 5

In children who is most likely to affected by osteomyelitis?

Answer 5

Boys and kids under 10 years old

Question 6

What are the risk factors for developing osteomyelitis?

Answer 6

• Open bone fracture
• Orthopaedic surgery
• Immunocompromised
• Sickle cell anaemia
• HIV
• TB

Question 7

How does osteomyelitis present?

Answer 7

Acute with an unwell child or chronically with subtle features
- Refusing to use limb or weight bear
- Pain
- Swelling
- Tenderness
- Afebrile or low grade fever

Question 8

What investigations are used for osteomyelitis?

Answer 8

X-rays, initial investigation but can be normal

MRI best for diagnosis

CRP, ESR and WCC - raised
Blood culture
Bone marrow aspiration or biopsy with histology and culture may be needed

Question 9

How is osteomyelitis managed?

Answer 9

Prolonged antibiotics

May need surgery for drainage and debridement of infected bone