Osteomyelitis Flashcards
What is the limitation of using blood culture as a means of diagnosis?
Bacteria are only present in the blood in 30% of the presenting cases
Which part of the bone do bacteria typically infect?
In looped capillaries around the metaphysis
What is septic arthritis?
Infection of a joint, usually via haematogenous spread
Which bacteria is common agent of infection after in very young children?
Grp B Strep
Hib
Other gram negatives
How does osteomyelitis differ in children compared to adults?
In children the infection is able to cross the growth plate while in adults it isn’t
What are some common presenting symptoms of osteomyelitis?
Pain
Pseudoparalysis
Fever
Malaise
Limp in children
What is the standard treatment for osteomyelitis?
Flucloxacilin (best vs staph) for 3-5 days IV then 3 weeks oral if uncomplicated
Cefotaxime added in neonates to cover gram negs
Where is osteomyelitis causing Staph typically acquired?
It is a communsal carried on the body
Which bacteria is common agent of osteomyelitis after chicken pox?
Strep. pyogenes
Which bones are more commonly infected?
Long bones particularly:
Femur
Humerus
Tibia
What are the best imaging techniques for osteomyelitis?
MRI
Bone scan
How can osteomyelitis be identified on X-ray?
Bulging of the periosteum
What is the most common means by which bacteria get to a joint to infect it?
Haematogenous spread
What are some differential diagnoses for osteomyelitis?
Septic arthritis
Bone metastases
Cellulitis
What is the limitation of X-ray as a means of diagnosing osteomyelitis?
Most of the time it’s difficult to detect anything until peristeal lifting is present
