Osteomyelitis

Question 1

Osteomyelitis is more common in children compared to adults and usually affects the long bones. true or false?

Answer 1

True

Question 2

infections in adults often occur in the……

Answer 2

vertebrae or the hips.

Question 3

How osteomyelitis infection spreads?

Answer 3

In osteomyelitis the infection can spread under the periosteum causing localised warmth, swelling, erythema and tenderness to that area of the body

Question 4

Define Osteomyelitis

Answer 4

Osteomyelitis is an infection of the bone, this is also associated with the inflammation of the bone and the bone marrow.

Question 5

List the two infection stages in osteomyelitis

Answer 5

I. Mild phase

2. Severe phase

Question 6

Facts about the mild stage of Osteomyelitis

Answer 6

Patients suffering from mild infection will experience no weakness to the bone and they will be able to continue to weight bare on any infected leg.

Question 7

Facts about severe stage of osteomyelitis

Answer 7

These infections are more problematic to the patient, as the structural integrity of the bone is damaged. The patient will not be able to weight bare, the infected area will be very painful and they are also susceptible to breakages

Question 8

There are a number of organisms associated with osteomyelitis, the organisms are more diverse depending on the age of the patient. True/false

Answer 8

True

Question 9

In the patient age group - new born to adulthood the following organisms can be associated with osteomyelitis:

Answer 9

• Staphylococcus aureus
• Streptococcus pyogenes
• Streptococcus agalactiae
• Haemophilus influenzae
• Enterobacter species

Question 10

Organisms associated with osteomyelitis in adult group are….

Answer 10

• Staphylococcus aureus
• Salmonella species
• Streptococcus species

Question 11

State the causes of osteomyelitis

Answer 11

• A pre existing infection – travels to the bone. This is often through haematological spread of the organism.
• Injury – bone fracture, particularly if this is from a dirty wound, allowing the organism entry. Also an open fracture will allow organisms associated with our normal flora to enter this area of the body.
• Post surgery infection – hip replacement. Osteomyelitis can also be associated with healthcare associated infections as a result of surgery.
• Pre-existing conditions, predisposing patients to infection such as diabetes, immunocompromised patients, malnutrition, conditions resulting in poor circulation and IV drug misuse.

Question 12

Imaging techniques in Osteomyelitis

Answer 12

1. CT scan
2. X- ray
3. MRI Scan

Question 13

Treatments of osteomyelitis

Answer 13

Depends on the organism that is sensitive, youd be provided with a biogram in the exams

Flucloxacillin
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection

If penicillin-allergic, clindamycin
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection
If meticillin-resistantStaphylococcus aureussuspected, vancomycin (or teicoplanin)

Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection

Question 14

Symptoms of Osteomyelitis

Answer 14

• Leg appears swollen, warm and tender( right tibia)
• Unable to bear weight on examination
• No cutaneous skin lesion at all