Osteomyelitis Flashcards
What area of bone is most commonly affected by pediatric osteomyelitis?
Metaphysis via hematogenous seeding; 50% of pediatric patients are
What is the most common bacteria a/w pediatric osteomyelitis?
S. aureus; MRSA becoming more common
Can have PVL (Panton-Valentine leukocidin) protein which is more common in complex MRSA infections
What are certain cases where certain organisms are more commonly associated in pediatric osteomyelitis?
Puncture wound to foot- pseudomonas
Neonates- group B strep
Young children- Kingella kingae
Sickle cell- salmonella
What is the most common bacteria a/w pediatric osteomyelitis?
S. aureus; MRSA becoming more common
Can have PVL (Panton-Valentine leukocidin) protein which is more common in complex MRSA infections
Which joints have intra-articular metaphyseal portion?
Hip, shoulder, elbow and ankle
Important in that wrist and knee arthrosepsis does not come from regional spread
What are the definitions of involucrum and sequestrum?
Involucrum- layer of new bone growth outside existing bone seen in osteomyelitis
Sequestrum- layer of new bone growth outside existing bone seen in osteomyelitis
What imaging studies can be helpful in diagnosis of pediatric osteomyelitis?
X-ray- can show heterotopic bone, lucency
MRI- 88-100% sensitive; low signal T1, high signial T1 w/ contrast, high signal T2
Bone scan- can be cold if agreesive
What role do ESR and CRP play in the diagnoses for pediatric osteomyelitis?
CRP elevated w/in 6hrs of infection; can show response to tx in 48-72hrs
ESR elevated in 90% of patients; rises quickly
What are the indications for surgical debridement of pediatric osteomyelitis?
1) deep or subperiosteal abscess
2) failure of abx therapy
3) chronic infxn
4) frank pus on aspiration
What are the Risk factors for the development of a DVT in children with osteomyelitis?
1) surgical treatment
2) CRP > 6
3) MRSA
4) age > 8 years
