Osteomyelitis

Question 1

What is osteomyelitis?

Answer 1

It is defined as a condition in which there is infection of bone and bone marrow

Question 2

Which bones tend to be affected by osteomyelitis?

Answer 2

Long Bones

Question 3

Which region of bones tend to be affected by osteomyelitis?

Answer 3

Myelitis = Metaphysis

Question 4

What are the two classifications of osteomyelitis?

Answer 4

Haematogenous Osteomyelitis

Non-Haematogenous Osteomyelitis

Question 5

What is haematogenous osteomyelitis?

Answer 5

It is defined as bone infection, which is introduced through the blood, after entering the body through another route

Question 6

What is non-haematogenous osteomyelitis?

Answer 6

It is defined as bone infection, which is related to contiguous spread of infection from adjacent soft tissues or from direct injury/trauma

Question 7

What eleven risk factors are associated with osteomyelitis?

Answer 7

Children < 10 Years Old

Male Gender

Open Bone Fracture

Orthopaedic Surgery

Immunocompromised

Diabetes Mellitus

Peripheral Arterial Disease

Sickle Cell Anaemia

HIV Infection

Tuberculosis

Intravenous Drug User

Question 8

What are the six clinical features of osteomyelitis?

Answer 8

Fever > 38C

Bone Pain

Limb Swelling

Limb Erythema

Limb Warmth

Inability To Weight Bear

Question 9

What five investigations are used to diagnose osteomyelitis?

Answer 9

Blood Tests

Blood Culture

X-Ray Scans

MRI Scans

Bone Biopsy

Question 10

What three blood test results indicate osteomyelitis?

Answer 10

Increased WBC Levels

Increased CRP Levels

Increased ESR Levels

Question 11

How are blood cultures used to diagnose osteomyelitis?

Answer 11

They are used to identify the causative organism, in order to guide antibiotic management

Question 12

What is the most common infective organism of osteomyelitis?

Answer 12

Staphylococcus aureus

Question 13

What is the most common infective organism of osteomyelitis - in sickle cell anaemia?

Answer 13

Salmonella species

Question 14

What are the three features of osteomyelitis on x-ray scans?

Answer 14

Focal Bony Cortex Lysis

Periosteal Reactions

Periosteal New-Bone Formation

Question 15

What is the gold standard investigation used to diagnose osteomyelitis?

Answer 15

MRI Scans

Question 16

What are the two features of osteomyelitis on MRI scans?

Answer 16

Bone Marrow Oedema

Cortical Bone Destruction

Question 17

How are bone biopsies used to diagnose osteomyelitis?

Answer 17

They are used to identify the causative organism, in order to guide antibiotic management

Question 18

What are the two pharmacological management options of osteomyelitis?

Answer 18

Beta-Lactam Antibiotics

Macrolide Antibiotics

Question 19

When are beta-lactam antibiotics used to diagnose osteomyelitis?

Answer 19

They are the first line pharmacological management option

Question 20

Name a beta-lactam antibiotic used to manage osteomyelitis

Answer 20

Flucloxacillin

Question 21

When are macrolide antibiotics used to manage osteomyelitis?

Answer 21

They are the second line pharmacological management option

Question 22

Name a macrolide antibiotic used to manage osteomyelitis

Answer 22

Clindamycin

Question 23

Describe the antibiotic course used to manage osteomyelitis

Answer 23

They are administered IV for a prolonged course of 4 – 6 weeks

Question 24

What is the surgical management option of osteomyelitis?

Answer 24

Drainage & Debridement

Question 25

What is drainage & debridement?

Answer 25

It involves incision to the soft tissues surrounding the infected bone, in order to enable drainage of the accumulated pus and removal of diseased bone

Question 26

What four complications are associated with osteomyelitis?

Answer 26

Chronic Osteomyelitis

Osteonecrosis

Septic Arthritis

Skin Cancer