Osteomyelitis Flashcards
What is osteomyelitis?
Inflammation of bone and bone marrow due to bacterial infection
What is haematogenous osteomyelitis?
Pathogen carried through blood and seeded in the bone
What is the most common mode of infection of osteomyelitis?
Haematogenous spread
may also occur due to direct contamination
What is the most common causative organism of osteomyelitis?
Staphylococcus aureus
What are the risk factors for developing osteomyelitis?
Open fractures
Orthopaedic operations
Diabetes
PAD
IVDU
Immunosuppression
What is the chance of infection of prosthetic joints?
1%
More likely to occur in revision surgery
How does osteomyelitis present?
Fever
Pain and tenderness
Erythema
Swelling
What are the potential signs of osteomyelitis on x-ray?
X-rays often do not show changes in early disease
Periosteal reaction- changes to bone surface
Localised osteopenia
Destruction to bone
What is the best imaging for diagnosis osteomyelitis?
MRI
What do blood tests show in osteomyelitis?
Raised inflammatory markers
WBC
CRP
ESR-especially in osteomyelitis
What needs to be done to treat osteomyelitis?
Blood and bone cultures to detect causative organism
How is osteomyelitis managed?
Surgical debridement
Antibiotics
What antibiotics are used to treat acute osteomyelitis?
6 weeks flucloxacillin
Flucloxacillin infiltrates the bone most effectively
+ Rifampicin or fusidic acid for the first 2 weeks
What can be used instead of flucloxacillin?
Clindamycin in penicillin allergy
Vancomycin or teicoplanin when treating MRSA
How long is antibiotic treatment in chronic osteomyelitis?
3 months or more
