Osteomyelitis Flashcards
1
Q
Definition
A
Infection in bone either acute, chronic or specific
2
Q
Epidemiology
A
.
3
Q
Pathophysiology
A
Haemotogenous spread
Long bones occasionally breaking into joint capsules for a infective arthritis
Local spread from open fractures, or bone surgery
Start of metaphysics (trauma?) Venous congestion & arterial thrombosis Acute inflammation Suppuration (pus) Release of pressure Necrosis of the bone New bone formation
4
Q
Etiology/Risk Factors
A
Cause: Infants: Staph Aureus (most common) Group B streptococci E.Coli Children: Staph Aureus (most common) Strep pyogenes Adults: Staph Aureus (most common) Pseudomanas aeroginosa (sharp object through a trainer) Coagulase negative staphlococci
Risk Factors: Young Age Boys > Girls History of trauma In adults: - Diabetes - RA - Steroid treatment - Immune compromised
5
Q
Presentation
A
Infant:
- Failure to thrive
- Drowsy & Iratible
- Decresed ROM
- Tenderness
- Positional change
- May be multiple sites
Children:
- Sever pain
- Reluctant to move from a flexed position
- Fever with swinging pyrexia
- Tachicardia
- Toxirima
Primary Adults:
- Commonly in throacolumbar spine
- Back ache
- History of UTI
- Commodities
- Tachicardia
Secondary Adults (common): -
6
Q
Lab Work Up
A
WBC (nurotrophils)
Elevated ESR & CRP
U&Es (dehydrated)
3x Blood cultures
7
Q
Imagining
A
X-Ray imaging (normal in the begging) Ultrasound (pus) Aspiration Bone scan with TC-99 MRI (using more than bone scan)
8
Q
Complications
A
Metastatic infection Pathological fracture Septic arthritis Septicaemia (death) Chronic osteomyelitis Altered bone growth (epithelial involvement)
9
Q
Differential Diagnosis
A
Septic arthritis
Trauma
Transient synovitis (hip)
Acute inflammatory arthritis
10
Q
Treatment
A
Rest Analgesia Rehydration therapy Antibiotics (IV leading to Oral) - Flucloxcillin & Benzyl penicillin Generally before 24-48hours
Surgery
- If suppuration is present
- Abscess drainage (antibiotics can’t reach)
- Decompresses the cavity
- Remove necrotic tissue
- Infected joint replacement
11
Q
Prognosis
A
.
12
Q
Histology
A
.
