Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Rheumatology > E: Septic Arthritis + Osteomyelitis > Flashcards

E: Septic Arthritis + Osteomyelitis Flashcards

(60 cards)

Start Studying
1
Q

What is septic arthritis

A

Infection of a joint

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

How does bacterial contamination of a joint occur

A
  • Haematogenously

- Direct contamination

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

How can infection from the blood stream occur

A
  • From a distant site (eg. abscess)

- Or, disseminated infection (eg. gonorrhoea)

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

How does direct contamination occur

A
  • Trauma

- Iatrogenic (eg. arthroscopy)

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

What is the most common cause of septic arthritis

A

Staphylococcus aureus

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

What may cause septic arthritis in sexually active patients

A

N. Gonorrhoea

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

What are 5 risk factors for septic arthritis

A
  • Old age
  • Diabetes
  • Immunocompromised
  • Prosthetic joints
  • IVDU
  • Chronic skin infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the clinical presentation of septic arthritis

A
  • Fever
  • Reduced range of movement
  • Pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How will a joint appear in septic arthritis

A

Erythematous, swollen joint

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

What blood tests may be performed in septic arthritis

A

FBC
ESR
CRP

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

What is gold-standard investigation of septic arthritis

A

Joint aspiration

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

What is joint fluid aspirate obtained for

A
  • Culture
  • Cell count
  • Gram stain
  • Glucose
  • Crystal analysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How will joint aspirate fluid appear in septic arthritis

A

Cloudy (due to being purulent)

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

What WCC is diagnostic for septic arthritis

A

> 50,000 in native joints.

Often >1,100 in prosthetic joints

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

How will glucose appear in joint aspirate in septic arthritis

A

<60% of serum glucose

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

What imaging is recommended for septic arthritis

A

Lateral and AP x-rays

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

What is the Kocher criteria used for

A

Differentiate septic arthritis as a cause of hip pain in children (often compared to transient synovitis of the hip)

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

How is septic arthritis managed

A

IV Vancomycin (30mg/kg/day) for 2W, then switch to Vancomycin PO for 4W. And joint aspiration.

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

If an individual is allergic to vancomycin, what should be used

A

Clindamycin or cephalosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are 4 factors that may indicate gram-negative septic arthritis

A

Old age
Recurrent UTI
Recent abdominal surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is used to manage gram-negative septic arthritis

A

IV Ceftriaxone 2g/24h and joint aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is osteitis

A

infection of the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is osteomyelitis

A

infection of the bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

in which age group does haematogenous ostemyelitis tend to occur

A

children and adolescents.

50% of cases occur in under 5y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
in which age group does vertebral osteomyelitis tend to occur
adults
26
what is haematogenous osteomyelitis
haematogenous spread of a disseminated pathogen
27
what is the most common cause of haematogenous osteomyelitis
s.aureus
28
what are 4 exogenous causes of osteomyelitis
- Trauma - Iatrogenic - Secondary infection from diabetic foot ulcer - Contigous spread from adjacent tissue
29
what are 3 local risk factors for osteomyelitis
- Open fracture - Soft tissue damage - Poor perfusion
30
what are 3 systemic factors for osteomyelitis
- Immunocompromised - Systemic disease - IVDU
31
how long does it take for acute osteomyelitis to occur
sudden onset over hours-days
32
how long does it take for chronic osteomyelitis to occur
onset over months-years
33
how will acute osteomyelitis present
- Pain at infection site - Joint is tender, erythematous, warm, swollen - May be fever, malaise
34
in infants what is the most common site of osteomyelitis
Metaphysis of long bone
35
in children, what is the most common site of osteomyelitis
Metaphysis of long bone
36
in adults, what is the most common site of osteomyelitis
Vertebrae
37
what is chronic osteomyelitis and how will it present
occurs following previous episode of osteomyelitis and may persist for months
38
what pathogen commonly causes osteomyelitis
s. aureus
39
what organism tends to cause osteomyelitis in diabetic patients with foot ulcers
s. epidermis
40
what organism may cause osteomyelitis in patients with prosthesis
s. epidermis. Although due to prevalence s.aureus more commonly causes osteomyelitis in patients with prosthetics
41
what organism may cause osteomyelitis in IVDU
pseudomonas auerginosa
42
what organism may cause osteomyelitis in plantar puncture wound (particularly if rubber footwear is worn)
pseudomonas auerginosa
43
what organism may cause osteomyelitis in sickle cell patients
salmonella
44
what organism may cause osteomyelitis in patients with recurrent UTI
enterobacteria
45
what investigations are ordered in osteomyelitis
``` FBC CRP ESR Blood culture X-ray MRI ```
46
what is the problem with WBC for identifying osteomyelitis
only raised in 1/3 of patients
47
What does ESR show
if ESR decreases following treatment it is a good prognostic indicator
48
What is the most sensitive test in osteomyelitis
CRP (97% raised in osteomyelitis)
49
What may positive blood cultures indicate
Disseminated haemotegenous infection. Although is often negative in osteomyelitis
50
What is the problem with x-ray for acute osteomyelitis
It takes 2W for evidence of infection to present on x-rays
51
what is the gold standard for identifying osteomyelitis
MRI
52
what sign is seen on MRI in osteomyelitis
penumbra sign
53
what is the penumbra sign
a dark abscess in the centre with hyper intense thin ring of white sclerosis around the outside
54
what is used as a confirmatory test for osteomyelitis
bone biopsy
55
why is a bone biopsy performed
to look at histology, be able to perform gram stain and culture
56
what is the management of osteomyelitis
IV Flucloxacillin for 6W
57
what should patients with osteomyelitis also be considered for and why
Surgical debridement. If patients have necrotic tissue or a biofilm it will not heal without debridement
58
what scoring system is used to predict prognosis in osteomyelitis
Cierney-Mader Classification
59
what are 4 complications of osteomyelitis
- Sepsis - Amputation - Marjolin's Ulcer (malignant transformation) - Chronic osteomyelitis
60
what typically causes chronic osteomyelitis and what is a risk factor for this
- Presence of SCC | - RF: presence of a chronic draining sinus

Rheumatology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions