osteomyelitis

Question 1

definition of osteomyelitis

Answer 1

BONE INFECTION basically

Osteomyelitis is an inflammatory condition of bone caused by an infecting organism, most commonly Staphylococcus aureus. It usually involves a single bone but may rarely affect multiple sites.

Severity can be staged depending on the aetiology of the infection, its pathogenesis, extent of bone involvement, duration, and host factors particular to the individual patient. Broadly, bone infection is either haematogenous (AKA FROM BLOOD INSIDE) (originating from bacteraemia) or contiguous focus (AKA FROM SKIN OUTSIDE) (originating from a focus of infection adjacent to the area of osteomyelitis). Despite these different causes all forms of acute osteomyelitis may evolve and become chronic, sharing a final common pathophysiology, with a compromised soft-tissue envelope surrounding dead, infected, and reactive new bone.

Question 2

symptoms

Answer 2

• non specific pain at site of infection
• malaise and fatigue
• local inflammation, erythema, swelling
• low grade fever

Question 3

signs

Answer 3

• wound drainage
• scars, previous flaps
• reduced range of movement
• reduced sensation in diabetic foot ulcer

Question 4

risk factors

Answer 4

• penetrating injury
• surgical contamination
• intravenous drug misuse
• DM
• peridontitis (Periodontal abscess can result in osteomyelitis of the mandible. The mandible is much more susceptible to osteomyelitis than the maxilla because the cortical plates of the mandible are thin and its medullary tissues have relatively poor vascular supply.)

Question 5

investigations

Answer 5

1st investigations:
ESR
CRP
WBC
plain x rays of affected area 

others to consider:
ultrasound
MRI
CT
radionuclide scans 
histology