Osteomyelitis Flashcards
Osteomyelitis is acutely inflamed and infected ____ _____
bone marrow
In children, the infection in osteomyelitis is most commonly h_____ spread
haematogenous
In adults, the infection in osteomyelitis is most commonly ____
local
What microorganism most commonly causes osteomyelitis?
Staph aureus
What organism commonly causes osteomyelitis in sickle cell patients?
Salmonella
What are risk factors for osteomyelitis?
IVDU
Immunosuppression
PVD
DM
Sickle cell anaemia
Inflammatory arthritis
Trauma
Acute bone change leads to i_____ and b___ o____
inflammation and bone oedema
What are 2 complications of chronic bone change in osteomyelitis?
Sequestra
Involucrum
What is sequestra?
Necrotic bone embedded in pus
What is involucrum?
Thick sclerotic bone placed around sequestrae to compensate and provide support.
What are symptoms of acute osteomyelitis?
Dull bony pain
Hot and swollen area
Worsens with movement
What are symptoms of chronic osteomyelitis
Dull bony pain
Hot and swollen area
Worsens with movement
Deep ulcers (sequestrae)
What other condition presents very similarly to osteomyelitis?
Charcot joint
What causes Charcot joint?
Diabetic neuropathy damaging sensory nerves
What is Charcot joint?
Progressive degeneration of weight bearing joint and bony destruction. Often affects foot, presents with “diabetic feet”
How do you diagnose osteomyelitis?
Bone marrow biopsy and culture, MC+S
ESR and CRP raised
XR showing osteopenia
After X-ray, an MRI, shows bone marrow oedema
What is treatment for osteomyelitis?
Immobilisation and antibiotics
May involve surgical debridement of infected tissue
What antibiotic is given for MRSA?
Vancomycin or Teicoplanin (longer lasting but has more side effects like pruritis)
What antibiotic is used for staph aureus in osteomyelitis?
Fusidic acid
What antibiotics is used for salmonella causing osteomyelitis?
Flucloxacillin
What type of osteomyelitis must be ruled out?
Tuberculosis osteomyelitis
How do you diagnose for tuberculosis osteomyelitis?
Bone marrow biopsy which is caseating granuloma positive
What is a caseating granuloma?
Central area of necrosis (caseating)
surrounded by macrophages and immune cells
Can an x-ray be used to exclude osteomyelitis?
No because it doesn’t show the changes in early disease.
However if it ahs been present for a while, may see:
Periosteal reaction
Localised osteopenia
Destruction of areas of the bone
Chronic osteomyelitis typically requires _ months or more of antibiotics to treat
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