OSTEOMYELITIS

Question 1

What is osteomyelitis?

Answer 1

infection of bone

Question 2

What is the most common infecting organism of osteomyelitis in the UK?

Answer 2

-staph aureus

Question 3

Describe the pathophysiology of osteomyelitis

Answer 3

• routes of bacterial spread being either direct or haematogenous
• infection with a subsequent inflammatory response, abscess formation (like the tuberculous “Potts abscess”), ischaemia and hence bone death (sequestrum)
• New bone can occur (involucrum) as can the development of sinuses (cloacae) in severe disease which then discharge pus

Question 4

What are the risk factors for osteomyelitis?

Answer 4

• DM
• IVDU
• Sickle cell anaemia
• Immunosuppression due to either medication or HIV
• Alcohol excess

Question 5

What are the signs and symptoms of osteomyelitis?

Answer 5

Signs
Local tenderness and deformity

Symptoms
Fever, malaise, fatigue

Question 6

What are the investigations for osteomyelitis?

Answer 6

• Bloods - Raised ESR and WCC

- MRI - because the inflammation caused is best seen on MRI

Question 7

What is the treatment of osteomyelitis?

Answer 7

Non-Pharmacological
-If it’s spinal then bed rest

Pharmacological

• Flucloxacillin for 6 weeks - clindamycin if penicillin-allergic
• Triple therapy if it’s caused by TB

Surgical
-Sometimes removal of dead bone and drainage of abscesses is required