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Pod practice > Osteomyelitis > Flashcards

Osteomyelitis Flashcards

1
Q

What is the definition of osteomyelitis?

A

Acute inflammation of the bone caused by a bacterial infection.

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2
Q

Where does osteomyelitis commonly occur in children?

A
  • arms, legs, hips, shoulders, wrists
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3
Q

Where does osteomyelitis commonly occur in adults?

A
  • spine, feet, pelvis
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4
Q

What are the most common causes of osteomyelitis?

A
  • blood borne infection secondary to respiratory/renal/UTI
  • cellulitis
  • open wound over a bone
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5
Q

What are the predisposing factors for osteomyelitis?

A
  • PVD
  • Peripheral Neuropathy
  • Diabetes
  • Open #
  • Surgery/injection
  • Orthopaedic/dental
  • Immuno-suppressed
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6
Q

What are the signs and symptoms of osteomyelitis?

A
  • fever/irritability/fatigue
  • nausea
  • tenderness/swelling
  • loss of ROM if near a joint
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7
Q

Treatment for osteomyelitis is based on…

A
  • causative agent/bacteria
  • route by which infection reached the bone
  • duration of infection
  • local and systemic factors
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8
Q

What is the pathogenesis of osteomyelitis?

A

Bacteria hides in osteoblasts - secretes pus - spreads to vascular channels - impairs blood flow - acute becomes chronic infection - ischaemic necrosis of bone (no living osteocytes)

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9
Q

What are the types of osteomyelitis?

A
  • Acute hematogenous
  • Secondary osteomyelitis
  • Sub-acute
  • Chronic development
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10
Q

What is acute hematogenous osteomyelitis?

A
  • infection arises in blood
  • predominantly in children
  • commonly in metaphysis of long bones
  • commonly in the spine in adults and in IV drug users
  • usually history of blunt trauma that has created a haematoma
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11
Q

What are the symptoms of acute hematogenous osteomyelitis?

A
  • fever
  • chills
  • localized pain/tenderness
  • decreased ROM/ability to WB
  • erythema
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12
Q

What is secondary contiguous osteomyelitis?

A
  • secondary to contiguous infection
  • common in adults
  • usually secondary to an open wound
  • other causes include bites, open #, surgical procedures or foreign bodies
  • diagnosis not usually made until chronic infection present and sinus present
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13
Q

Risk of chronic osteomyelitis is increased in those with…

A
  • PVD
  • Diabetes
  • decreased neurovasc status
  • infection
  • poor healing due to poor tissue perfusion
  • frequent trauma due to neuropathy
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14
Q

How is osteomyelitis diagnosed?

A
  • PROBE TO BONE
  • clinical findings (subjective and objective)
  • lab tests
  • x-rays, MRI and CT
  • histopathologic and microbiologic assessment (GOLD STANDARD)
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15
Q

What is chronic suppurative osteomyelitis?

A
  • a complication of chronic osteomyelitis
  • the necrotic bone forms a sequestrum of dead bone that spurs on the infection
  • multiple sinuses can occur
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16
Q

Is acute hematogenous osteomyelitis polymicrobial?

A

No, it is usually infected by a single organism. Most common is staph aureus. Secondary contiguous infection is more likely to be polymicrobial.

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17
Q

Treatment of osteomyelitis involves…

A
  • antimicrobial management (oral or IV antibiotics)
  • surgical debridement
  • drainage of pus
  • stabilization of bone
  • amputation
  • chronic wound management
18
Q

What type of benign bone tumours are there?

A
  • osteochondroma
  • osteoblastoma
  • osteoid osteoma
  • giant cell tumour
19
Q

Describe osteochondroma.

A
  • contains cartilage and bone

- common to growth plates of long bones

20
Q

Describe osteoblastoma.

A
  • solitary bone neoplasm
  • common to vertebrae of children and young adults
  • short and flat bones are most affected
21
Q

Describe osteoid osteoma.

A
  • benign osteoblastic tumour of unknown aetiology

- most often in long bones

22
Q

Describe giant cell tumour.

A
  • most common of benign tumours
23
Q

What is the treatment for benign bone tumours?

A
  • surgery

- monitor

24
Q

What is a primary malignant lesion?

A
  • originated in bone

- bone cells that become cancerous then spread through the bloodstream to other sites

25
Q

What is a secondary malignant lesion?

A
  • cancerous cells from another site (e.g. breast) spread through the bloodstream and infiltrate the bone
26
Q

Describe osteosarcoma.

A
  • most common type of primary malignant bone tumours
  • usually in metaphysical regions of long bones
  • penetrates and destroys bone cortex and extend to surrounding tissue
27
Q

What are the symptoms of osteosarcoma?

A
  • frequent pain in areas
  • swelling
  • decreased ROM
28
Q

Describe Ewing’s Sarcoma.

A
  • primary malignant bone tumour
  • common in teenagers
  • common in pelvis, hips, femur or tibia
  • can sometimes see in soft tissue
29
Q

Describe chondrosarcoma.

A
  • primary malignant bone tumour
  • relatively rare
  • cancer of the cartilage cells
  • common in pelvis, femur, humorous and ribs
  • adults over 40
30
Q

Describe multiple myeloma.

A
  • a plasma cell tumour that can interfere with the production of blood cells
  • plasma cell proliferation causes skeletal destruction
  • plasmacytomas (accumulate in bone or soft tissue)
  • easily misdiagnosed as back pain in early stages
31
Q

What are the symptoms of multiple myeloma?

A
  • bone pain
  • persistant infection
  • anaemia
  • renal impairment
  • back pain/pathological #
  • symptoms of spinal cord or nerve root compression
32
Q

What is the treatment and prognosis of multiple myeloma?

A
  • no cure just symptoms control

- survival is 1-10 years with a average of 3 years

33
Q

What is osteoporosis?

A

Insufficient bone formation or excessive bone reabsorption. Bone becomes brittle and fragile. Bone loses minerals faster than it can replace.

34
Q

What is osteomalacia?

A
  • impairment of bone mineralization usually due to vitamin D
  • due to reduced sunlight or digestive kidney disease
  • bone reabsorption is faster than bone reformation
35
Q

What is Paget’s Disease?

A
  • accelerated skeletal remodelling
  • generally affects long bones and leads to enlarged bones and makes them spongy
  • unknown aetiology
36
Q

What are the symptoms of Paget’s Disease?

A
  • pain
  • bone deformity
  • #
  • arthritis
37
Q

How is Paget’s Disease diagnosed?

A
  • x-ray

- alkaline phosphatase test

38
Q

What is osteochondritis dissecans?

A
  • affects adolescents and young adults, commonly males
  • spontaneous loss of blood supply to bone and adjacent cartilage
  • symptoms include joint pain and loss of ROM
  • treated with surgical removal
39
Q

What is osteogenesis imperfecta?

A
  • genetic disorder - mutation of COL1A1 and COL1A2 gene
  • increased bone fragility, low bone mass, connective tissue problems
  • associated with blue sclera, hearing loss, hyper laxity of ligaments, spinal curvature, triangular face, muscle weakness
40
Q

What is the treatment of osteogenesis imperfecta?

A
  • physiotherapy
  • surgery
  • braces
  • orthoses

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