Osteomyelitis

Question 1

Define osteomyelitis

Answer 1

Infection of the bone from haematogenous spread, direct inoculation or contiguous spread

Question 2

What are the causes/risk factors of osteomyelitis?

Answer 2

Causes
• Staphylococcus aureus
• Haemophilus influenza
• Salmonella
• Group A streptococcus

Risk Factors
• Penetrating injuries
• IVDU
• Diabetes
• HIV
• Surgery
• Periodontitis

Question 3

What are the symptoms of osteomyelitis?

Answer 3

• Pain
• Fever
• Malaise
• Fatigue

Question 4

What are the signs of osteomyelitis?

Answer 4

• Erythema
• Tenderness
• Swelling
• Reduced ROM
• Wound drainage/sinus tracts

Question 5

What investigations are carried out for osteomyelitis?

Answer 5

• FBC - leukocytosis
• Blood Cultures - positive for causative organism.
• ESR/ CRP - elevated
• Joint Aspiration - positive; performed if there is joint infection or an abscess.
• X-Ray - radiographic changes usually lag at least 2 weeks behind the infection’s evolution. The earliest changes seen are soft-tissue swelling, periosteal thickening, and focal osteopenia. Lytic changes will not usually be indicated until at least 50% of the bone matrix is destroyed.
• CT/ MRI - will show bone inflammation and destruction