Osteomyelitis Flashcards
Define “osteomyelitis”
inflammation of the bone and medullary cavity
What is osteomyelitis commonly caused by?
open fractures drug injection prosthetic joint infection vascular insufficiency diabetes specific hosts and pathogens
How is osteomyelitis diagnosed?
GOLD - bone biopsy
cross sectional imaging also useful (MRI)
What is the most common pathogen that causes osteomyelitis?
staph aureus
What is the acute treatment of osteomyelitis? - if patient has sepsis
presume its staph aureus and give empirical flucoxacillin IV and surgery to debride
What is the chronic treatment of osteomyelitis?
await bone biopsy results to determine what pathogen it is and then treat with antibiotics PO (ie flucox or metranidizole)
What is the presentation of vertebral osteomyelitis?
50% presents without symptoms such as fever or back pain, 90% have raised inflammatory markers
How is vertebral osteomyelitis investigated?
MRI
Ga-67 scan
How is vertebral osteomyelitis treatment?
drainage of paravertebral or epidural abscesses
antimicrobials for 6 weeks
In what populations does haemotogenous osteomyelitis occur?
drug injectors - strep and staph
prepubertal children
people with central lines/dialysis lines - staph
Where does clavical osteomyelitis come from?
neck surgery
Where does oestitis pubis come from?
urogynae procedures
What is sickle cell osteomyelitis due to?
salmonella and staph aureus
What is Gauchers disease?
a lysomal storage disorder affecting the tibia
it mimics bone crisis - if not bone crisis then it is Gauchers and is caused by staph aureus
Describe SAPHO (adults) and CRMO (kids)?
recurrent lytic lesions on xrays that resemble osteomyelitis
presents with fever, weight loss and general malaise
there is increased inflammatory markers
