Osteomyelitis

Question 1

Primary bacteria that causes osteomyelitis? Most of the time ^ but could be?

Answer 1

Staphylococcus aureus Osteomyelitis could also be biofilm

Question 2

Two ways it’s spread

Answer 2

hematogenous spread: most common - spreads from infection elsewhere to bone. Risk factors: IVDU, immune deficient, sepsis, trauma, indwelling IV catheter non-hematogenous: direct inoculation, contiguous (from adjacent tissue - this can be orthopedic hardware

Question 3

In adults, hematogenous spread more common to…

Answer 3

spine, pelvis, and small bones

Question 4

Inflammatory response osteomyelitis

Inflammation extends into…

What is lifted from inflammation? Necrosis and death of bone leads to? What is new bone formation called?

Answer 4

Remember small vessel thrombosis and abscess formation

Extends into bone marrow:

• periosteum is lifted, disrupting blood supply
• necrosis and death of bone leads to sequestrum
• stimulates osteoblast activity leading to formation of new bone: involucrum

-In adults, infection weakens cortex leading to pathologic fractures

Question 5

Acute Osteomyelitis - abrupt onset of inflammation: fever, pain, necrotic bone (prior to formation of sequestra)

Can be either _______ or _______

Answer 5

-exogenous: outward signs of inflammation with local pain, swelling, fever, and purulent drainage

-adult hematogenous: has insidious onset - vague symptoms: fever, malaise, anorexia, wt loss

*recent infection or instrumentation (ortho s.)

*pain in affected area: spine, sacroiliac

Question 6

Which information is correct regarding the pathophysiologic process of osteomyelitis?

Answer 6

Sequestrum (dead bone)