Osteomyelitis

Question 1

what is the typical presentation of osteomyelitis in adults and in children?

Answer 1

Children long bones - inflam + reduced mobility + fever

Adults - pott’s disease (TB)

Question 2

Define osteomyelitis?

Answer 2

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

Question 3

what are the 2 causative organisms of ostemyelitis?

Answer 3

Staphylococcus aureus- main

Group A Streptococcus

Question 4

outline the aetiology of osteomyelitis?

Answer 4

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

Question 5

what are the risk factors for osteomyelitis?

Answer 5

diabetes

immunosupression

IV durg use

prostheses

periodonitis abscess

sickle cell anaemia: salmonella and staph

cellulitis/ localised infection

injury

Question 6

summarise the epidemiology of osteomyelitis?

Answer 6

Mostly in YOUNG CHILDREN

< 20% of cases are in adults

Question 7

what are the presenting symptoms of osteomyelitis?

Answer 7

Pain in the affected area

Fever

Malaise

Rigors

History of preceding skin lesion, sore throat, trauma or operation

NOTE: infants may not show localising signs

Question 8

what are the signs of osteomyelitis on physical examination?

Answer 8

Tenderness

Swelling

Warmth

Painful/limited movement of affected limb

Seropurulent discharge from an associated wound or ulcer

Question 10

what are the appropriate investigations for osteomyelitis?

Answer 10

bloods

swabs of wound or discharge

radiographs- x-ray- show periosteal thickening, osteopaenia, soft tissue swelling

MRI- most sensitive

Radioisotope bne scan- show signs of increased activity