Infection of Bone and Soft Tissue

Question 1

What bacteria are likely to affect an INFANT in relation to acute osteomyleitis of heamatogenous origin?

Answer 1

Staph Aureus
Group B Streptococci
E.Coli

Question 2

What bacteria are likely to affect a CHILD in relation to acute osteomyleitis of heamatogenous origin?

Answer 2

Staph A
Step Pyogenes
H. Influenza

Question 3

An adult is suffering from a case of acute osteomyelitis of Heamatogenic origin. They have a PROSTHETES what are the most likely organisms at work?

Answer 3

Coagulase -ve Staphylococci

Propionibacterium Species

Question 4

An adult is suffering from a case of acute osteomyelitis of Heamatogenic origin. They have a INFECTIOUS ARTHITIS what are the most likely organisms at work?

Answer 4

Strep Pyogenes

Question 5

An adult is suffering from a case of acute osteomyelitis of Heamatogenic origin. They have a PREVIOUS FOOT INJURY what are the most likely organisms at work?

Answer 5

Pseudomonas aeroginosa

Question 6

An adult is suffering from a case of acute osteomyelitis of Heamatogenic origin. They have PREVIOUS IVDA what are the most likely organisms at work?

Answer 6

Pseudomonas aeroginosa

Question 7

What is a sequestrium?

Answer 7

devascularisation of a portion of bone with necrosis and resorption of surrounding bone leaving a ‘floating’ piece

Question 8

Why may a sequestrium act as reservoir for infection?

Answer 8

Avascularity of the sequestrium means that antibiotics may not be able to penetrate it

Question 9

What is an involucurum?

Answer 9

a layer of new bone growth outside existing bone seen in pyogenic osteomyelitis. It results from the stripping-off of the periosteum by the accumulation of pus within the bone, and new bone growing from the periosteum.

Question 10

What symptoms may be present in a child suffering from Acute Osteomyelitis?

Answer 10

SEVER PAIN - reluctant to move, not weight bearing, tender and inflammed
FEVER
MALAISE

Question 11

Where will Primary Osteomyelitis present in an adult?

Answer 11

Thoracolumbar spine fever

Backache

Question 12

What is the most common DDx’s for OM?

Answer 12

Cellulitis
Eryspielas
Necrotising Fasciitis
Gas Gangrene
Toxic Shock Syndrome

Question 13

What is brodies abscess?

Answer 13

a localised form of subacute osteomyelitis, with a predilection to the long bones of the lower extremities
It has a characteristic intermittent pain of long duration and localised swelling of the area

Question 14

What is subacute OM in relationship to bacteria and immune response?

Answer 14

Less bacterial virulence and more host resistance related

Question 15

Ddx for Subacte OM

Answer 15

Ewings Sarcoma

Question 16

What are the organisms responsible for acute septic arthritis?

Answer 16

Staph Aureus
H. Inf
Strep Pyog
E. Coli

Question 17

How does acute septic arthritis lead to complete destruction of the articular cartilage?

Answer 17

1. Acute synovitis w/ purulent joint effusion
2. Leads to articular cartilage attacked by bacterial toxin and cellular enzymes
3. Complete destruction of articular cartilage

Question 18

What are the three Classifications of Tb in Bones and Joints?

Answer 18

Extra-articular - epiphyseal bones w/ haemodynamic marrow

Intra-Articular - large joints

Vertebral Body