Infections, gout and pseudogout Flashcards
(35 cards)
Which organism is the most common cause of septic arthritis?
Staphylococcus aureus
Give 8 risk factors for septic arthritis
Rheumatoid arthritis Diabetes mellitus Immunosuppression Renal failure Joint surgery Prosthetic joints IV drug use Age over 80 years
What may ultrasound show in septic arthritis?
Joint effusion
What is the management of septic arthritis?
IV then oral antibiotics for a total of 3 weeks; consider orthopaedic review for arthrocentesis, washout and debridement
Which organism is the most common cause of osteomyelitis?
Staphylococcus aureus
Which organism is the most common cause of osteomyelitis in IV drug users?
Pseudomonas aeruginosa
Which organism is the most common cause of osteomyelitis in sickle cell disease?
Salmonella
Give 3 ways that osteomyelitis can occur
Haematogenous spread
Direct inoculation
Direct spread from nearby infection
What makes chronic osteomyelitis difficult to treat with antibiotics?
Devascularisation and necrosis causing antibiotics to not be able to penetrate
What is an involucrum?
Region encased in a thick sheath of periosteal new bone?
Which bones are most often affected by osteomyelitis in adults?
Vertebrae
Which bones are most often affected by osteomyelitis in children?
Long bones
What is Pott’s disease?
Infection of vertebral body and intervertebral disc by Mycobacterium tuberculosis
Give 4 risk factors for osteomyelitis
Diabetes mellitus
Immunosuppression
Alcohol excess
IV drug use
In which group of people might osteomyelitis prevent without pain?
Diabetics
What might X rays show in osteomyelitis?
Osteopenia
Periosteal thickening
Endosteal scalloping
Focal cortical bone loss
How long after infection does it take for X rays to show changes in osteomyelitis?
7-10 days
What is the gold standard investigation for osteomyelitis?
Culture from bone biopsy at debridement
What is the management for osteomyelitis (clinically stable, no bone destruction)?
4-6 weeks IV antibiotics tailored to cultures
What is the management for osteomyelitis (deterioration or bone destruction on MRI)?
Surgical curettage or debridement
What causes gout?
Inflammation due to monosodium urate crystals
Give 5 things that might precipitate attacks of gout
Surgery Starvation Infection Trauma Diuretics
What skin condition is associated with an increased risk of gout?
Psoriasis
Give 2 classes of drugs that increase the risk of gout
Chemotherapy
Diuretics
