Osteomyelitis

Question 1

Define Osteomyelitis?

Answer 1

Infection of the bone leading to inflammation, necrosis and new bone formation
Can be acute, subacute or chronic

Question 2

What are the two causative organisms of Osteomyelitis?

Answer 2

Staphylococcus aureus

Group A Streptococcus

Question 3

What is the aetiology of Osteomyelitis?

Answer 3

Bacterial infection from indirect inoculation from skin (e.g. trauma, operative, chronic skin ulcers, haematogenous spread)

Question 4

What are the risk factors for Osteomyelitis?

Answer 4

Diabetes 
Immunosuppression
IV drug use 
Prostheses 
Sickle-cell anaemia

Question 5

What is the epidemiology of Osteomyelitis?

Answer 5

Mostly in YOUNG CHILDREN

<20% of cases are in adults

Question 6

What are the presenting symptoms of Osteomyelitis?

Answer 6

Pain in the affected area
Fever 
Malaise 
Rigors 
History of preceding skin lesion, sore throat, trauma or operation 
Infants may not show localising signs

Question 7

What are the signs of Osteomyelitis?

Answer 7

Localised erythema
Tenderness
Swelling
Warmth
Painful/limited movement of affected limb
Seropurulent discharge from an associated wound or ulcer

Question 8

What investigations do you do for Osteomyelitis?

Answer 8

Bloods
Swabs of wound or discharge
Radiographs
Radioisotope bone scan

Question 9

What bloods do you do for Osteomyelitis?

Answer 9

FBC
Blood Culture
ESR
CRP

Question 10

Why do we do Radioisotope bone scan for Osteomyelitis?

Answer 10

Shows areas of increased activity