Osteomyelitis Flashcards
Definition
Inflammation of bone and medullary cavity due to infection
Where does the infection come from?
Blood steam (haematogeneous spread)
Nearby tissue
Can start in the bone itself (trauma)
Commonly affected bones in children
Long bones
Commonly affected bones in adults
Vertebrate
Commonly affected bones in diabetics
Feet
Who gets it?
Extremes of age
Cause
Post-trauma
Open fracture
Diabetes
Immunocompromised
Most common causative organism
staph aureus
Pathology
Once infected, osteolysis occurs and pus forms
Pus builds up and impairs local blood flow - this makes the infection more difficult to eradicate
pus can eventually end up in the joint cavity resulting in necrosis of adjacent bone (sequestrum)
Clinical features
Inflammatory symptoms (calor, rubor, dolor, tumor, function lasea)
Tenderness over affected area
Unable to weight bear
Systemic upset
Examination
Look for patients bone with naked eye
Use a probe to probe bone
Investigations
Bone biopsy - gold standard
Blood tests
Imaging
Management
Remove pus and remove any dead or diseased bone
Await microbiological diagnosis before starting antibiotics
6 weeks IV antibiotics
Vertebral osteomyelitis - definition
Infection of the intervertebral disc spaces
Infection due to haematogenous spread
Vertebral osteomyelitis - who gets it
PWID
Poorly controlled diabetics
Epidural abscess
