Osteomyelitis

Question 1

Define osteomyelitis

Answer 1

Infection of the bone leading to inflammation, necrosis & new bone formation

Can be:
Acute
Subacute
Chronic

Question 2

Aetiology of osteomyelitis

general + 2 organisms

Answer 2

Bacterial infection from indirect inoculation from skin (e.g. trauma, operative, chronic skin ulcers, haematogenous spread)

Causative organisms
Staphylococcus aureus
Group A streptococcus

Question 3

Risk factors for osteomyelitis

5

Answer 3

Diabetes 
Immunosuppression
IV drug use
Prostheses
Sickle cell anaemia

Question 4

Epidemiology of osteomyelitis

age x2

Answer 4

Mostly in YOUNG CHILDREN

< 20% cases are in adults

Question 5

Presenting symptoms of osteomyelitis

5

Answer 5

Pain in affected area
Fever
Malaise
Rigors
History of preceding skin lesion, sore throat, trauma or operation

Question 6

Signs of osteomyelitis on physical examination

6

Answer 6

Localised erythema
Tenderness
Swelling
Warmth
Painful/limited movement of affected limb
Seropurulent discharge from associated wound or ulcer

Question 7

Investigations for osteomyelitis

4 types

Answer 7

Bloods

Swabs of wound or discharge

Radiographs

Radioisotope bone scan

Question 8

Investigations for osteomyelitis - bloods

4

Answer 8

FBC
Blood culture
ESR
CRP

Question 9

Investigations for osteomyelitis - radioisotope bone scan

Answer 9

Shows area of increased activity