Osteomyelitis - Week 13 PBL

Question 1

Definition of osteomyelitis?

Answer 1

Infection (staph aureus most common) of bone via open fracture or haematogenous spread or surgery

Question 2

Who does osteomyelitis affect?

Answer 2

Less than 20 yrs and over 50 more commonly
Less than 10 in children

Question 3

Risk factors of osteomyelitis?

Answer 3

Immunosuppression
· HIV
· IV drug user
· Open fracture
· Surgery
· Diabetes
* sickle cell anaemia

Question 4

Causative organisms for osteomyelitis?

Answer 4

Staph A - gram pos cocci
Pseudomonas aeruginoa - gram neg rod
Salmonella - gram neg rods
Neisseria gonorrhoea - gram neg diplococci
Mycobacterium tuberculosis -

Question 5

Presentation of osteomyelitis?

Answer 5

Deep bone pain
· Fever
· Erythema
· Swelling
· Signs of local inflammation
Gradual onset pain
Unable to weight bear

Question 6

Investigations of osteomyelitis?

Answer 6

Rise in inflammatory markers
Bloods - FBC, U&E, CRP, LFT, ESR, hbA1c
Microbiology, MSU urine, blood cultures

Question 7

Imaging for osteomyelitis?

Answer 7

MRI
Sequestrum = refers to dead piece of devitalised bone that has been separated due to necrosis from the surrounding bone
o Involucrum = new growth of periosteal bone around a sequestrum
o Cloaca = opening in an involucrum that allows the internal necrotic bone and pus to discharge out

Question 8

Management of osteomyelitis?

Answer 8

IV antibiotics and surgery to clean wound