Bone Infections

Question 1

acute hematogenous osteomyelitis occurs in who?

Answer 1

kid

Question 2

in kids where does acute hematogenous osteomyelitis affect the bone?

Answer 2

only metaphyses because no blood getting into epiphyseal since they make a u turn at the mataphysis

Question 3

what is most common cause of acute hematogenous osteomyelitis?

Answer 3

transient bacteremia originating from another area

Question 4

what are the four main implications of inoculation of acute hematogenous osteomyelitis?

Answer 4

bone resorption
Thrombosis
pus under pressure
spread through adjacent canals

Question 5

with acute hematogenous osteomyelitis is there more bone formation or resorption?

Answer 5

bone resorption

Question 6

how can osteomyelitis infect a joint if epiphysis is guarding it?

Answer 6

the joint have intracapsular growth that attached to mataphysis

Question 7

name the four bones that have intracapsular growth of joints and can get infected easier due to attachment of joint to the metaphysis?

Answer 7

distal fibula (ankle)
radial neck (elbow)
proximal humerus (shoulder)
proximal femur (hip)

Question 8

how does osteomyelitis appear in Xray?

Answer 8

lucency in metaphysis

Question 9

what are common sites for acute hematogenous osteomyelitis in kids?

Answer 9

proximal humerus
proximal tibia
distal femur
proximal femur

Question 10

how does acute hematogenous osteomyelitis present?

Answer 10

pain tenderness and fever (not always fever though)

Question 11

what markers will be elevated in acute hematogenous osteomyelitis?

Answer 11

ESR and CRP

Question 12

what are two Xray findings with acute hematogenous osteomyelitis?

Answer 12

periosteal elevation and lucency

Question 13

how long does acute hematogenous osteomyelitis take to show up on Xray

Answer 13

1-2 weeks

Question 14

what is treatment for acute hematogenous osteomyelitis?

Answer 14

abx

decompression and debridement

Question 15

what is organism for native joint infection?

Answer 15

Staph Aureus

Question 16

what is organism for prosthetic joint?

Answer 16

coag neg staph like staph epi

Question 17

what are two complications of acute hematogenous osteomyelitis?

Answer 17

infectious arthritis and chronic osteomyeltis

Question 18

how does chronic osteomyelitis appear on imaging?

Answer 18

looks like a bone within a bone…affected bone on middle and reparative new bone around it

Question 19

what is the name of the dead bone in chronic osteomyelitis?

Answer 19

sequestrum

Question 20

what is the name of the new bone in chronic osteomyelitis?

Answer 20

involucrum

Question 21

what can chronic osteomyelitis lead to in bones?

Answer 21

sinus tract formation

Question 22

what can sinus tract formation in chronic osteomyelitis lead to?

Answer 22

marjolin ulcer and squamous cell carcinoma

Question 23

what is treatment for chronic osteomyelitis?

Answer 23

abx and remove the sequestra

Question 24

what are common sites for septic arthritis?

Answer 24

hips and knees

Question 25

if you have septic arthritis in sternoclavicular joint...what is cause?

Answer 25

IV drug use

Question 26

what is most common cause of septic arthritis?

Answer 26

hematogenous most common...sometimes from penetrating injury or bone infection

Question 27

what is the worst thing that septic arthritis leads to in kids?

Answer 27

chondrocyte death...so no bone growth

Question 28

what are four clinical findings of septic arthritis?

Answer 28

classic infectious...tumor rubor calor dolor

Question 29

how is hip held when you have septic arthritis?

Answer 29

flexed and externally rotated

Question 30

what is the PE finding with septic arthritis?

Answer 30

irritated joint with effusion of joint

Question 31

what joint might you not see effusion with?

Answer 31

hip

Question 32

what is key diagnostic step to determine if joint effusion is from septic arthritis?

Answer 32

joint aspiration

Question 33

what will joint aspiration show in case of septic arthritis?

Answer 33

high WBC count over 50,000 with over 90% PMNs

Question 34

what are acute complications of a septic arthritis?

Answer 34

osteomyelitis and dislocation

Question 35

what are long term complications of a septic arthritis?

Answer 35

growth deformity

Question 36

what two things can bacteria produce around a prosthetic joint?

Answer 36

glycoalyx | biofilm

Question 37

what is the common organism in infected shoulder replacement?

Answer 37

P. acnes