Bone & Soft Tissue Infection Flashcards
What is infection of the bone referred to as?
Osteomyelitis
How is osteomyelitis classified?
1) Acute
2) Chronic
1) Specific (e.g. TB)
2) Non-specific (most common)
What is the pathological process involved in bone infection?
- Spreads from metaphysis (possibly caused by trauma?)
- Leukocytes release enzymes which lyse the bone
- Spread of infection from metaphysis results in venous congestion and arterial thrombosis
- Acute inflammation occurs as a result of the infection and produces increased pressure
What is the most common bacteria involved in acute osteomyelitis?
Staph Aureus
What are the common sources of infection in osteomyelitis?
1) Spread via blood
2) Local spread from site of infection - trauma, bone surgery
3) Vascular insufficiency
What is the aetiology of acute osteomyelositis?
Acute osteomyelitis:
- Mostly children
- Boys > girls
- History of trauma
- Common with other diseases (diabetes, RA, immune compromised, long-term steroids)
What are the common bacterias involved in chronic osteomyelitis?
- Staph Aureus
- E. Coli
- Strep Pyogenes
What are the clinical features of an infant with osteomyelitis?
1) Failure to thrive
2) Metaphyseal tenderness + swelling
3) Decreased range of motion
4) Knee most commonly affected
What are the clinical features of a child with osteomyelitis?
1) Severe pain
2) Reluctant to move and not weight bearing
3) Fever and tachycardia
4) Malaise
What are the clinical features of an adult with osteomyelitis?
1) Commonly seen in thoracolumbar spine (primary)
2) Backache
3) History of UTI
4) Elderly, diabetic, immunocompromised
5) Secondary OM after open fractures or surgery
What are the differential diagnosis of acute osteomyelitis?
1) Acute septic arthritis
2) Acute inflammatory arthritis
3) Trauma
4) Transient synovitis
5) Soft tissue infection
What are the clinical features of acute septic arthritis in a neonate?
1) Irritability
2) Resistant to movement
3) ill
What are the clinical features of acute septic arthritis in a child/adult?
1) Acute pain in single large joint
2) Reluctance to move joint
3) Increased temperature and pulse
4) Increased tenderness
What are the differential diagnosis of acute septic arthritis?
1) Acute osteomyelitis
2) Trauma
3) Haemophilia
4) Rheumatic fever
5) Gout
What are the investigations and expected results of acute osteomyelitis?
1) Clinical examination - raised temp and pulse
2) ESR, CRP - raised
3) FBC - Raised neutrophils
4) Blood cultures - +ve
5) U+E’s - dehydrated
