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2a MSK and Rheumatology > Osteomyelitis > Flashcards

Osteomyelitis Flashcards

1
Q

Osteomyelitis is acutely inflamed and infected ____ _____

A

bone marrow

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2
Q

In children, the infection in osteomyelitis is most commonly h_____ spread

A

haematogenous

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3
Q

In adults, the infection in osteomyelitis is most commonly ____

A

local

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4
Q

What microorganism most commonly causes osteomyelitis?

A

Staph aureus

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5
Q

What organism commonly causes osteomyelitis in sickle cell patients?

A

Salmonella

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6
Q

What are risk factors for osteomyelitis?

A

IVDU
Immunosuppression
PVD
DM
Sickle cell anaemia
Inflammatory arthritis
Trauma

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7
Q

Acute bone change leads to i_____ and b___ o____

A

inflammation and bone oedema

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8
Q

What are 2 complications of chronic bone change in osteomyelitis?

A

Sequestra
Involucrum

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9
Q

What is sequestra?

A

Necrotic bone embedded in pus

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10
Q

What is involucrum?

A

Thick sclerotic bone placed around sequestrae to compensate and provide support.

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11
Q

What are symptoms of acute osteomyelitis?

A

Dull bony pain
Hot and swollen area
Worsens with movement

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12
Q

What are symptoms of chronic osteomyelitis

A

Dull bony pain
Hot and swollen area
Worsens with movement
Deep ulcers (sequestrae)

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13
Q

What other condition presents very similarly to osteomyelitis?

A

Charcot joint

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14
Q

What causes Charcot joint?

A

Diabetic neuropathy damaging sensory nerves

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15
Q

What is Charcot joint?

A

Progressive degeneration of weight bearing joint and bony destruction. Often affects foot, presents with “diabetic feet”

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16
Q

How do you diagnose osteomyelitis?

A

Bone marrow biopsy and culture, MC+S
ESR and CRP raised
XR showing osteopenia
After X-ray, an MRI, shows bone marrow oedema

17
Q

What is treatment for osteomyelitis?

A

Immobilisation and antibiotics
May involve surgical debridement of infected tissue

18
Q

What antibiotic is given for MRSA?

A

Vancomycin or Teicoplanin (longer lasting but has more side effects like pruritis)

19
Q

What antibiotic is used for staph aureus in osteomyelitis?

A

Fusidic acid

20
Q

What antibiotics is used for salmonella causing osteomyelitis?

A

Flucloxacillin

21
Q

What type of osteomyelitis must be ruled out?

A

Tuberculosis osteomyelitis

22
Q

How do you diagnose for tuberculosis osteomyelitis?

A

Bone marrow biopsy which is caseating granuloma positive

23
Q

What is a caseating granuloma?

A

Central area of necrosis (caseating)
surrounded by macrophages and immune cells

24
Q

Can an x-ray be used to exclude osteomyelitis?

A

No because it doesn’t show the changes in early disease.
However if it ahs been present for a while, may see:
Periosteal reaction
Localised osteopenia
Destruction of areas of the bone

25
Q

Chronic osteomyelitis typically requires _ months or more of antibiotics to treat

A

3

2a MSK and Rheumatology (31 decks)

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