Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > bone and joint infection > Flashcards

bone and joint infection Flashcards

1
Q

What is osteomyelitis

A

Bone infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is septic arthritis

A

joint infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who is most at risk of acute osteomyelitis

A

Children
Males
History of trauma
Adults with other diseases such as diabetes which cause immunosuppression
People who have had sickle cell disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the infection begin in acute osteomyelitis

A

Most commonly the infection is somewhere in the body and haematogenously spreads to the bone

There can be local spread from a continuous site of infection e.g open fracture

People with poor vasculation are prone to infections of the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In infants what is the source of infection for osteomyelitis

A

Infected umbilical cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In children what is the most common sources of infection in osteomyelitis

A

Boils
Tonsilitis
Skin abrasions
Chicken pox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In adults what is the most common source of infection for osteomyelitis

A

UTI, arterial line, chest infection, gall bladder infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common organism which causes the osteomyelitis

A

Staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the common organisms which cause osteomyelitis in infants

A

Staph aureus
Group B strep
E.coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the common organisms which cause osteomyelitis older children

A

Staph aureus
Strep pyogenes
Haemophilus influenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the common organisms which cause osteomyelitis in adults

A

Staph aureus
coagulase negative staphylococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What bones is acute osteomyelitis most common in and why

A

Long bones, specifically the metaphysis e.g distal femur, proximal tibia and proximal humerus
This is because they have a larger blood supply since they are larger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe how osteomyelitis occurs - infection moving through blood to bone

A

The infection clumps and then travels in the circulation - it gets stuck like an arterial thrombus - causes the build up of back pressure - lymphocytes are sent there but this causes pus which causes more pressure - the pressure needs released so infection enters the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes pain in bone when there is increase in pressure

A

Pressure receptors in the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 sites where infection can infiltrate the bone

A

medulla, sub-periosteal or into joint resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a sequestrum

A

isolated piece of bone which has undergone necrosis due to no blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is involucrum

A

Formation of new bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the clinical features of acute osteomyelitis in infants

A

May be minimal or very ill
Drowsy or irritable and not feeding
Pseudoparalysis - not moving a limb
Tendon at the bone with swelling
reduction of movement
Commonest at the knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the clinical features of acute osteomyelitis in children

A

Severe pain
Reluctant to move
Pyrexia and tachycardia
Malaise
Toxaemia

20
Q

What are the clinical features of acute osteomyelitis in adults

A

Backache - unremitting and at rest
History of UTI or urological procedure
Usually immunocompromised

21
Q

What is the most common osteomyelitis location in adults

A

Thoracolumbar spine

22
Q

How is osteomyelitis diagnosed (what are the investigations done)

A

History and clinical examination
FBC +WBC
ESR +CRP - inflammation markers
Blood cultures
U&Es
X-ray
US
bone biopsy
MRI

23
Q

What is the differential diagnosis of osteomyelitis (other diagnosis options)

A

Soft tissue infection - cellulitis
Acute septic arthritis
Trauma
acute inflammatory arthritis
transient synovitis

24
Q

What is the treatment of acute osteomyelitis

A

Antibiotics are the main treatment - IV because the bone isolates the infected blood supply
Analgesia and fluids for pain and dehydration (supportive treatment)
Surgery - not common

25
Q

What is the indication for surgery in acute osteomyelitis

A

Aspiration of pus and abscess draining from bone via drilling into bone if pyrexia is prolonged after antibiotic treatment

26
Q

What are the complications of acute osteomyelitis

A

Metastatic infection - infection spreads to different areas of the body
Pathological fracture
Septic arthritis
Septicemia
Altered bone growth through damaged epiphyseal growth plate
Chronic osteomyelitis

27
Q

What organisms cause chronic osteomyelitis

A

Usually mixed but mainly staph aureus

Other common are E.coli, strep pyogenes and proteus

28
Q

What is the treatment of chronic osteomyelitis

A

Local antibiotics - gentamicin cement
Systemic antibiotics - orally/IV
To try to cure - surgical eradication of the dead bone which is infected

29
Q

What are the complications of osteomyelitis

A

Chronically discharging sinus
Metastatic infection
pathological fracture
growth disturbance and deformities
Squamos cell carcinoma

30
Q

What is the route of infection of septic arthritis

A

Haematogenous
eruption of bone abscess
Direct invasion - penetrating wound

31
Q

What are the common organisms that cause septic arthritis

A

Mainly Staph aureus

Haemophilus influenzae
Strep pyogenes
E.coli

32
Q

What happens in acute septic arthritis

A

Acute synovitis and purulent joint effusion
Articular cartilage attacked by bacterial toxin and cellular enzymes
Complete destruction of articular cartilage

33
Q

How does septic arthritis present in neonates

A

Irritabile
Resistance to joint movement

34
Q

How does septic arthritis present in children and adults

A

Severe acute pain in a single large joint
Reluctancy to move the joint
swelling
erythema in the later stage
pyrexia and tachycardia
tenderness

35
Q

What is the differential diagnosis for septic arthritis

A

Acute osteomyelitis
trauma
irritable joint
hameophilia
rheumatic fever
gout
Gaucher’s disease

36
Q

What is one of the most common causes of acute septic arthritis in adults

A

Infected joint replacement

37
Q

What is the treatment for acute septic arthritis

A

Antibiotics for 3-4 weeks
supportive measure - analgesia and fluids
Surgical drainage to let pus out the joint

38
Q

Why is TB a great mimic

A

Presents in different forms and can present in the joint and as osteomyelitis

39
Q

What are the clinical features of TB

A

insidious onset & general ill health
contact with TB
pain (esp. at night), swelling, loss of weight
low grade pyrexia
joint swelling
decrease ROM
ankylosis
Progressive deformity

40
Q

What is ankylosis

A

stiffness of the joint

41
Q

describe how TB spreads in the body

A

Starts in the gut or the lungs usually - then spreads elsewhere and commonly lodges into the vertebral joint and infects it

42
Q

What are the signs seen in TB for diagnosis

A

Long history
Single joint involvement
Thickened synovium
Marked muscle wasting
Periarticular osteoporosis

43
Q

What is periarticular osteoporosis

A

Low bone mass around a joint

44
Q

What are the investigations done for TB

A

FBC,ESR - elevated
Mantoux test - tuberculin is put in the skin and causes red colour around it
Sputum/urine culture
Increased white cell count
X-ray
Joint aspiration and biopsy

45
Q

What is the treatment of TB

A

Mainly antibiotics
Initially - rifampicin, isoniazid, ethambutol and then rifampicin and isoniazid for 8 weeks
Then prolonged treatment of rifampicin and isoniazid for 6-12 months

MSK (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions