Osteomyelitis

Question 1

What is osteomyelitis?

Answer 1

Bone infection

Question 2

What are the causes of osteomyelitis?

Answer 2

Hematogenous spread

- More common in pts

Question 3

What should be asked in MH concerning osteomyelitis?

Answer 3

Trauma
Surgical history
Immunocompromised
Systemic diseases

Question 4

What is observed in PE of osteomyelitis?

Answer 4

• Localized bone pain
• +/- sinus tract, swelling, abscess
• +/- constitutional symptoms

Question 5

What is diagnostic testing of osteomyelitis?

Answer 5

Plain films
MRI
CT scan
Bone Scan

Question 6

What is important about plain films in osteomyelitis?

Answer 6

14% sensitivity

76% specificity

Question 7

What is important about MRI in osteomyelitis?

Answer 7

Will see bone marrow changes

Question 8

What is important about CT scan in osteomyelitis?

Answer 8

Early cortical erosions

Question 9

What is important about bone scan in osteomyelitis?

Answer 9

High sensitivity

Low specificity

Question 10

What is the treatment of osteomyelitis?

Answer 10

• Very difficult to eradicate
• Debridement and excision of infected bone
• IV antibiotics based on culture and sensitivities
• Antibiotic impregnated methylmethacrylate beads

Question 11

What is involved with debridement and excision of infected bone in osteomyelitis?

Answer 11

• Antibiotic spacer
• Can reconstruct bone after infection clears
• Some cases amputation