Osteomyelitis AOH/ Spetic Arthritis

Question 1

Septic arthritis more common <2years of age after that decreases in incidence. True /False

Answer 1

True

Question 2

Most common M/o in AOH/SA

Answer 2

Staph aureus be aware increasing MRSA

Question 3

AHO common in children

Answer 3

Vascular anantormy. Sluggish blood flow
Phagocytosis decreased and low oxygen sat
Trauma 30%

Question 4

Presentation of AHO

Answer 4

Fever 60%
Unwell unhappy child
Acute signs of inflamation of the metaphysis redness warmth swelling POINT BONY TENDERNESS loss of nearby joint function

Question 5

Ix X-rays etc

Answer 5

X-rays 10 days to show up
USS subperiosteal abcess adjacent septic arthritis
Bone scan multifocal equivocal neonate difficult spot eg spine/pelvis
MRI if bone scan equivocal other problem

Question 6

Treat AHO with antibiotics high dose iv if not getting better Ix

Answer 6

Aspirate for culture
Drainage of abcess
Debridement of dead tissues
Bx dd leukemia/lymphoma

Question 7

Subacute OM. BODYS abcess

Answer 7

Delayed diagnosis common slow onset intermittent pain
Generally well bloods normal
Becoming increasing common
DD lymphoma/leukemia

Question 8

Septic arthritis

Answer 8

3routes blood AHO, trauma 
Sites knee/hip 70% ankle 13% shoulder 8%
Sign really sick refuse to weight bear severe pain 
High fevers 
Bloods WCC./CRP/ESR elevated
USS very useful effusion Y/N 
Synovical fluids MCS

DD Irritable hip/ reactive arthritis
Treatment is aspiration of joint / IV antibiotics high does

Question 9

Neonates have an immature immune system so in AHO or SA

Answer 9

Absent or minimal signs
Septicemia multifocal changes
AHO can quickly spread to SA

Question 10

Treatment of AHO /SA

Answer 10

High dose IV antibiotic for 3 days good clinical response

Oral antibiotics for 3-6 weeks

Question 11

DD of acute osteomyelitis

Answer 11

Trauma 
Tumor 
Ewings / osteosarcoma 
Leukemia 
Neuroblastoma
Eosinophilia granuloma