Week 2.6 Osteomyelitis

Question 1

how does acute osteomyelitis present

Answer 1

pain and tenderness in the affected area, described as deep and constant, which will cause an antalgic gait. inflammation, redness, warmth, fever, chills, sweating, nausea, malaise, swelling, may have pus or purulence.

Question 2

clinical presentation of vertebral osteomyelitis

Answer 2

localized LBP and tenderness, paravertebral muscle spasms, and radicular pain, extremity weakness causing SCI or nerve root compression

Question 3

chronic osteomyelitis clinical presentation

Answer 3

pain for month, intermittent bone pain and tenderness, not as painful as acute osteomyelitis.

Question 4

what are the three categories of the prosthetic joint infections

Answer 4

early less than 3 months post surgery
delayed 3-24 months
late (over 24 months)

Question 5

describe the early phase of joint infection

Answer 5

can get sinus tracts near incision, and have acute symptoms

Question 6

describe the delayed phase

Answer 6

lack systemic symptoms, but have joint pain and joint loosening.

Question 7

describe the late phase of joint infection

Answer 7

blood born infection that is seeding into the joint. joint pain, unexplained onset of increasing MSK symptoms in prosthetic joint

Question 8

what kinds of patient are at risk for osteomyelitis

Answer 8

malnutrition, renal and hepatic failure, immune disease, chronic hypoxia, extremes of age, impaired circulation
Deep pressure ulcers
IV drug users
s/p open fractures and implanted devices.

Question 9

what kind of lab work will be done

Answer 9

CBC: leukocytosis, elevated ESR and C-reactive protein

Question 10

what kinds of scans will be done

Answer 10

x-ray (not diagnostic)
CT (can show adjacent infection s or abscesses)
Bone Scan: can’t distinguish between infection, fractures and tumors

Question 11

what about a bone biopsy is important

Answer 11

to give definitive antibiotic treatment because we can culture what the actual infection is

Question 12

what is the role of PT in monitoring an preventing this

Answer 12

watch for pus at the incision line, and other clinical presentations

Question 13

how do you treat it

Answer 13

long term IV use, vancomycin, and 3rd/4th generation cephalosporin

Question 14

why might they need surgery

Answer 14

to drain the abscess, and for spinal instability, or to debride the dead bone. or remove the devices that are causing harm

Question 15

TF: you may need wound care and or amputation

Answer 15

true