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Flashcards in Musculoskeletal Infection Deck (100)
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1

What image modality is this and what condition do these findings demonstrate?

Sagittal MRI - Spondylitis Tuberculosis

2

- Diffuse infection of a muscle or muscle group

- Present with short history of fever and localized pain with passive movement of the muscle

- Staphylococcus aureus is most common organism

- Clostridial myonecrosis is an acute life-threatening form with surgical debridement often the only chance for survival

Pyomositis

3

What are the findings and differentials for this image?

4

What condition is shown here?

Cellulitis

(Soft tissue emphysema; could also be result of trauma)

5

Ultrasound, MRI and CT are useful in evaluation & differentiating with _____

Osteomyelitis

6

Suppurative Osteomyelitis in what age group?

- More insidious onset

- Local signs of inflammation, systemic signs of infection

- Common organisms: Staph aureus, pseudomonas, Klebsiella)

Adult (16+)

7

What is likely cause of these findings?

Suppurative Osteomyelitis

(Involucrum, cortical destruction)

8

What are these findings associated with?

Pathologic fracture secondary to Suppurative Osteomyelitis

(posterior angulation of segment, increased soft tissues)

9

Infection of periosteum =

Periostitis

10

What modality is used in his image & what condition is demonstrated?

Ultrasound

Cellulitis

11

What are the findings and differentials for this image?

12

What is likely the cause of these findings?

Infectious Spondylitis (Suppurative)

(ill-defined endplates, periarticular osteopenia of endplates)

13

In _____, hemtogenous spread in long bones of suppurative osteomyelitis occurs when:

- Vessels penetrate the closed growth plate

- Epiphyseal & metaphyseal region can be involved, as well as joint

- Joint involvement secondary to osteomyelitis is more common in this age group because of this

Adult (16+)

14

- Solid infected and inflamed tissue with intact blood supply, may progress to abscess

- MRI and or ultrasound can help differentiate with abscess

Phlegmon

15

Infection in a joint space =

Septic Arthritis

16

- Result of subacute or chornic osteomyelitis

- Sharply outline focus of burned out infection, may be sterile or contain residual Staph organism

- See oval or serpiginous lucency greater than 1cm in diameter & a variable zone of surrounding reactive sclerosis

- Likes distal tibia and knee

Brodies Abscess

17

Organisms causing septic arthritis enter in what means

Direct implantation

Hematogenous route

Extension from adjacent bone infection

18

What condition results in these findings?

Cellulitis

(Increased soft tissue, effusion, small vessel calcification; patient likely diabetic)

19

_____ is most common in lower extermity (hip & knee, spreads to these locations by traveling along psoas)

- initial infetion starts in metaphysis then spreads to joint

- Changes primarily joint related w/ adjacent bone destruction

- May result in fibrous ankylosis

Tuberculous Arthritis

20

____ is most common level involved in infectious spondylitis - non-supurrative

L1

21

Subligamentous spread is more common and may lead to anterior vertebral body erosio, psoas (cold) abscess, additional joint involvement (most common joint affected = hip)

= what condition

Infectious Spondylitis - Non-Suppurative

22

What are the findings and differentials for this image?

23

Acute ____ will demonstrate rapid destruction of bone

- 10 day laten period on x-ray

- Permeative or moth-eaten pattern of bone destruction

- Solid or laminated periosteal reaction

Suppurative Osteomyelitis

24

What is shown here?

Sacroilitis - Septic Arthritis

(Loss of joint space; monoarticular inflammatory arthritis → think infection)

25

What condition results in these findings?

Septic Arthritis

(Periarticular osteopenia, destruction of femoacetabular joint)

26

Suppurative Osteomyelitis in what age group?

- Males most commonly affected

- Acute onset of symptoms

- Local signs of inflammation, systemic signs of infection

- Common organisms: Staph aureus, salmonella

Childhood (1-16 yrs)

27

What imaging modality & condition is shown here?

Coronal MRI

Suppurative Osteomyelitis; abscess

28

This is an example of suppurative osteomyelitis via _____

Direct Implantation

29

What imaging modality & what condition is shown here?

MRI (T1 w/ contrast) - Suppurative Osteomyelitis

30

- Rapidly destructive infection along fascial planes

- Most often polymicrobial

- Solitary infection with Group A Streptococcal and Clostridium species may also be responsible

- Typically life-threatening requiring emergency surgery

- Diabetics at particular risk owing to immunocompromised and vascular insufficiency

Necrotizing fasciitis