Musculoskeletal

Question 1

Osteomyolitis - Exogenous

Answer 1

"outside in"
Et: open fx; IV; cellulitis
     *human - Staphlococcus aureus
     *animal - pasteurella multocida
PE: soft tissue s/s infection
Hx: IV abx, debridement

Question 2

Osteomyolitis - endogenous (hematogenous)

Answer 2

“inside-out” - bloodstream
infants>children>older adults; sickle cell anemia
Et: staph aureus
Hx: fever, malaise, anorexia, hx or infection or replacement surgery
Tx: IV abx, debridement, remove implant

Question 3

Mycotic Bone Infection

Answer 3

2nd to other infection
*candidiasis osteomycosis
*coccidioidomycosis: valley fever
Tx: oral azole antifungals

Question 4

Mycotic - Tuberculous Arthritis

Answer 4

Mycobacterium tuberculosis

• 2nd to lung infection; can be dormant
• monoarticular wks-months
• hip/knee, tenosynovitis of hand

Question 5

Reactive Arthritis (Reiter’s Syndrome)

Answer 5

2nd to GI/GU infection
*asymmetric sterile oligoarthritis; lower extremities
*low back pn, worse at night/morning
*extra-articular manifestations
Tx: abx; NSAIDs

Question 6

Septic Arthritis - nongonococcal

Answer 6

*staph aureus
*mono-articular; large weight bearing jts
*inflammation, abscess formation, effusion
Tx: I&D, abx, EMS

Question 7

Myositis

Answer 7

• viral, bacterial, parasite infection
• Tuberculosis & sarcoidosis
• Trichinellosis