osteomyelitis and septic arthritis Flashcards

1
Q

most common joint in septic arthrirtis

A

knee

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2
Q

septic arthritis how many joints

A

90% only one joint

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3
Q

tell-tale difference between chronic and acutre septic arthritis

A

chronic normally non-pyogenic

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4
Q

septic arthritis main risk factor. why

A

age iatrogenic

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5
Q

most common pathogenesis septic arthritis

A

haematogenous. blood-borne bacteria gets into joint somehow

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6
Q

most common pathogen septic arthritis

A

staph aureus

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7
Q

which bacteria can cause septic arthritis in <1 year olds (2)

A

HIB, haemophilus because pre-vacc

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8
Q

which STD can cause septic arthritis

A

gonorrhoea

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9
Q

investigations and results for septic arthritis

A

Elevated ESR (or CRP)
Neutrophilia (esp. in children)
Joint (synovial) fluid examination
Turbid or purulent
Leukocytes >50,000/mm3, pred. neutrophils
Gram stain positive in one-third
<25mg/dL glucose (much lower than serum)
Blood culture positive in one- to two-thirds

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10
Q

what do you get in mycobacterial septic arthritis if left untreated

A

Joint space narrowing
Effusion
Erosions
Cyst formation

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11
Q

what do you see accumulating here

A

fluid with osteomyelitis, Baker’s cyst

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12
Q

tx for septic arthritis

A

3-4 weeks IV abx

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13
Q

describe reactive (Reiter) arthritis

A

sterile arthritis normally post-infection

sausage toes and flaky skin, urethritis, uveitis

can’t see, can’t pee, can’t climb a tree

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14
Q

genetic rf for reactive arthritis

A

HLA-B27

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15
Q

which bones does tuberculosis normally infect first

A

vertebrae, also SI joint and hips via iliopsoas

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16
Q

imporant rf for osteomyelitis (think impaired blood supply)

A

DM and sickle cell

17
Q

what might you see in an infected joint replacement (5)

A

lucencies at bone-cement interface
changes in component position
cement fractures
Periosteal reactions
gas in joint

18
Q

gold standard tx for failed joint replacement

A

removal of prosthesis, antibiotics for 6wks, re-implantation of new prosthesis 4 weeks after removal - 90%+ success

19
Q

what is Pott’s disease

A

hunchback of notre dame
TB goes into spine, causing hump

20
Q
A