first signs of pyogenic osteomyelitis inf
Soft tissue swelling (bone takes 10 day latency)
x ray signs of pygogenic osteomyelitis
- Blured mm/fat interface
- moth eaten or permeative bone destruction (usually metaphysics)
- Laminated/codmans triangle periosteal rxn
In subacute pyogenic osteomyelitis what signs will you see
-timeframe
- More extensive bone destruction (lytic/ cortical destruction)
- <3m
- more insidious onset usually
What are the 3 signs of chronic osteomyelitis
Sequestrum- segment of necrotic bone (lytic destriction w thick collar around it)
Involucrum- collar of living bone surrounding the sequestered bone(linear piece of bone that sclerotic)
Cloaca- A defect in invilucrum wuch allows drainage(may look like lucent dot)
What is marjolins ulcer
When cloaca drains into soft tissue
- slow growing painless mass
- develops in area of chronic wounds
Bone appearence of pyogenic oteomyelitis
Moth eaten lytic destriction, osteoporotic and areas of sclerosis
-May see involucrum, sequestrum
Where will you see bone expansion in chronic pyogenic osteomyelitis
Bone expansion in the mid to distal diaphysis
Imaging findings of early and late chronic osteomyelitis
Early (days-weeks)- Soft tissue, periosteal rxn, subtle permiative bone destruction
Late (months)- Large moth eaten patten, periosteal rxn becomes thick, Look for cloaca etc
What is broadies abscess + pres
a localized form of suppurative osteomyelitis (doesnt expand along bone)
-Radiolucent nidus >1cm
Symptoms of brodies abscess
Osteoid osteoma like symptoms with night pain relieved by asprin
Mc sight of brodies abscess
Tibia
How early will symptoms be present on MRI for septic arthritis
Findings usually evident with 24hrs following onset
What signs on MRI will you see for septic arthritis
Synovial enhancement, perisynovial edema + joint effusion
Low signal on T1, high on T2
How long is the lateny period to see infection in spine
21 days
first sign of pyogenic infection in spine
Disc space narrowing
What signs will you see in pyogenic infection of spine
- Monoarticular lvl
- disc space narrowing
- endplate destruction
- altered alignment
What is an early sign of septic arthritis
-Distension of the Jt capsul (waldenstrons signs)
What teardrop distance is indicative of early septic arthris in hip
greater than 11mm or >2mm more than CL side
What will u see un late septic arthritis of hip
- rapid progrss of moth eaten destuction all around jt
- rapid narrowing of the jt spaces
- Potential for AVN
- Sequestration etc.
Location of toms smiths arthritis (3)
Bones w the metaphysis within the jt capsul
- prox/distal femur
- distal tib
- prox/distal humerus
Who is susseptible to tom smith arthritis
kids susseptivle as normally open growth palate inhibits spread but infection is in synovial fluid so can bypass
