Osteomyelitis and Septic Arthritis - Weisel

Question 1

Where is the usual anatomic location of hematogenous osteomyelitis?

(Where on the bone and where on the body)

Answer 1

Young infant - Metaphysis/Epiphysis (no blood vessels blocking spread)

Child - Metaphysis of long bones (spongy bone)

Adult - vertebrae

Femur, Tibia and Humerus are most common

Question 2

What is the pattern of osteomyelitis pathology?

Answer 2

Infection–>

• Inflammation
• Suppuration
• Necrosis
• New bone formation (abscess)
• Resolution

Question 3

Where are the most prevalent sites of infection in septic arthritis?

Answer 3

• knee
• hip
• ankle
• elbow
• wrist
• shoulder
• pelvis

Question 4

What is the purpose of aspiration in septic arthritis and what will it look like?

Answer 4

Color- Turbid, may be purulent
Cells- WBC (mostly neutroph.) 80,000-100,000, sometimes less
Gram Stain- Should be carried out
Chemistry- Lowered glucose level (relat. to serum)
Elevated protein
Cultures- Essential

For immediate treatment (in addition to irrigation)