Osteomyelitis Flashcards
(9 cards)
What are characteristics of growing pains?
3-12 years old
Symmetrical in lower limbs, not limited to joints
Never present at start of day after waking
Physical activities not limited, no limp
Physical examination normal
Symptoms often intermittent and worse after a day of vigorous activity
What is Osgood Schlatter disease? Who does it affect?
Tibial apophysitis - osteochondritis of patellar tendon insertion at knee
Inflammation at the tibial tuberosity
Traction by repeated avulsion of the apophysis into which the patellar tendon is inserted
Affects males who are physically active
Hamstring tightness
Conservative management
Physiotherapy
What are causes of acute limb pain
Trauma NAI Osteomyelitis Septic arthritis Bone tumours
What is osteomyelitis? Common sites? Cause?
Infection of the metaphysics of long bones
Distal femur and proximal tibia
Usually due to haematogenous spread
Staphylococcus aureus
Streptococcus
HAemophilus influenza
What are Sickle cell parties at risk of?
Staphylococcal and Salmonella osteomyelitis
What is presentation of osteomyelitis?
Painful immobile limb in child with acute febrile illness
Directly over the infected site there is swelling and tenderness
May be erythematous and warm
Severe pain on moving limb
May be effusion of adjacent joint
Back pain, limp, groin pain depending on where the infection is
What investigation in osteomyelitis?
Blood cultures
WCC
ESR
CRP
US may show periosteal elecation
MRI allows infection in bone to be seen
What treatment in osteomyelitis?
IV antibiotics for several weeks until clinical recovery followed by oral therapy
Aspiration or surgical decompression of the subperiosteal space may be performed if the presentation is atypical or in immunodeficiency
Surgical drainage if there is no response to abx
Splint and rest
Then subsequently mobilise
What are complications of osteomyelitis?
Bone necrosis
Chronic infection
Limb deformity
Amyloidosis
