Osteomyelitis (Bone Infection)

Question 1

Most common type of Osteomyelitis

Answer 1

non specific

Question 2

Acute Osteomyelitis population (4)

Answer 2

Children
Boys
History of Minor Trauma

Question 3

Acute Osteomyelitis source of infection in haematogenous

Answer 3

Children and Elderly

Question 4

Acute Osteomyelitis source of infection possibility (4)

Answer 4

Open Fracture
ORIF
Joint Replacement
Vascular insufficiency

Question 5

Source of osteomyelitis infection in infants

Answer 5

infected umbilical cord

Question 6

source of osteomyelitis infection in children (3)

Answer 6

boils
tonsilitis
skin abrasions

Question 7

source of osteomyelitis infection in adults (2)

Answer 7

UTI

Arterial Line

Question 8

Osteomyelitis organism in infants under 1 year (3)

Answer 8

Staph Aureus
Group B Strep
E Coli

Question 9

Osteomyelitis organism in older children (3)

Answer 9

Staph aureus
Strep pyogenes
H influenza

Question 10

Osteomyelitis organism in adults

Answer 10

Staph Aureus

Question 11

which osteomyelitis organism in those with prostheses (2)

Answer 11

coagulase neg staphylocci

propionibacterium spp

Question 12

In vertebral osteomyelitis organisms (2)

Answer 12

s aureus

tb

Question 13

in sickle cell disease osteomyelitis organism (1)

Answer 13

salmonella

Question 14

which bones can be affected by osteomyelitis (7)

Answer 14

long bones metaphysis

• distal femur
• prox tibia
• prox humerus

joints with interarticular metaphysis

• hip
• radial elbow

Question 15

Where does Acute Osteomyelitis start

Answer 15

Metaphysis

Question 16

What stages of Acute Osteomyelitis happen (6)

Answer 16

Vascular Stasis (Venous Congestion and Arterial Thrombosis)

Acute Inflammation

Suppuration

Release of Pressure

Necrosis of Bone (Sequestrum)

New Bone formation (involcrum)

Question 17

What is necrosis of bone called

Answer 17

sequestrum

Question 18

what is new bone formation called

Answer 18

involcrum

Question 19

Acute Osteomyelitis Features in Infant (5)

Answer 19

Fail to Thrive
Drowsy
Metaphyseal Tenderness and Swelling
Decrease ROM
Common Around Knee

Question 20

Where is Acute Osteomyelitis in Infant Common

Answer 20

Knee

Question 21

Acute Osteomyelitis in Children Features (7)

Answer 21

Severe Pain
Reluctant to Move
Joints Held Flexed
Swinging Pyrexia
Tachycardia
Malaise 
Toxaemia

Question 22

Acute Osteomyelitis Adult Features (4)

Answer 22

Common in Thoracocolumbar Spine
Backache
History of UTI or Urological Procedure
Elderly

Question 23

Acute Osteomyelitis common where

Answer 23

Thoracocolumbar Spine

Question 24

Diagnosing Acute Osteomyelitis (9)

Answer 24

History
FBC + WBC
ESR and CRP
Blood Culture x 3
X-Ray (Normal in first 10-14 Days
Ultrasound
Aspiration
Isotope Bone Scan
Labelled White Cell Scan

Question 25

When can changes start to be seen on radiographs for acute osteomyelitis

Answer 25

10-20 days early periosteal changes

Question 26

what is late osteonecrosis

Answer 26

sequestrum

Question 27

what is late periosteal new bone

Answer 27

involucrum

Question 28

Which scans for Acute Osteomyelitis (4)

Answer 28

Technetium-99m labelled diphosphonate Gallium 67 citrate delayed imaging Indium-111 labelled WBC scan MRI

Question 29

Technetium Scan should be done in what stages of acute osteomyelitis

Answer 29

Early and Late Phases

Question 30

Micrbiological diagnosis of Acute Osteomyelitis (3)

Answer 30

Blood Cultures Bone Biopsy Tissue or Swabs from up to 5 sites at Debridement in Prosthetic Infections

Question 31

Treatment of Osteomyelitis Acute

Answer 31

Rest and Splint | Antibiotics eg Fluclox and Benzylpen

Question 32

Indications for Surgery of Acute Osteomyelitis (4)

Answer 32

aspiration of pus for diagnosis & culture abscess drainage (multiple drill-holes, primary closure to avoid sinus) debridement of dead/infected /contaminated tissue refractory to non-operative Rx >24..48 hrs

Question 33

Complications of Acute Osteomyelitis (6)

Answer 33

``` metastatic infection pathological fracture septic arthritis septicemia, death altered bone growth chronic osteomyelitis ```

Question 34

Most common organism chronic osteomyelitis

Answer 34

Staph aureus

Question 35

chronic osteomyelitis affects which part of bone

Answer 35

involucrum and retained sequestra

Question 36

which cancer is associated with chronic osteomyelitis

Answer 36

squamous cell carcinoma