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21 Cards in this Set
- Front
- Back
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Inflammation of bone and marrow is usually due do ______ and ______ bacteria.
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Pyogenic
Mycobacteria |
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Purulence leads to _______ intraosseous pressure which leads to a _______ in blood flow.
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Purulence leads to INCREASED intraoss pressure
Leads to DECREASE in blood flow |
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What is a sequestrum and how is it formed?
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Sequestrum = necrotic bone that acts like a foreign body
Due to ischemic necrosis (decreased blood flow due to inc'd intraoss press) |
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What route of osteomyelitis is most common in children?
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HEMATOGENOUS
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Hematogenous osteomyelitis occurs in what bones in CHILDREN?
In what region of the bone does it begin? Why? |
LONG BONES (femur, humerus, tibia)
Starts in metaphysis, contained by epiphyseal growth plate, so normal growth not impaired Starts in metaphysis bc it's HIGHLY vasc'd |
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Hematogenous osteomyelitis occurs in what bones in ADULTS?
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Spine!
Starts at vertebral body endplate and spreads to involve then disk space then adjacent vertebra (Lumbar and thoracic most common) NOTE THAT IT IS NOT CONTAINED LIKE IT IS IN CHILDREN |
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Hematogenous osteomyelitis:
Mono/polymicrobial Microbes involved |
MONOMICROBIAL
Usually staph auerues Can also be E. coli (GB strep in neonates; GAS and H. influenzae in kids) |
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What route of osteomyelitis is most common in adults?
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OM secondary to CONTIGUOUS FOCUS or DIRECT INOCULATION of bacteria
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How does osteomyelitis of contiguous focus or direct inoculation occur?
What bones are involved? |
Bone is infected from external source (penetrating trauma, puncture wound, open fracture, dental work), PROSTHETICS
MAY INVOLVE ANY BONE |
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Osteomyelitis of contiguous focus or direct inoculation:
Mono/polymicrobial Microbes involved |
POLYmicrobial
Usually staph aureus (prosthetics: coag neg staph) ( |
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What route of osteomyelitis is most common in patients with diabetic neuropathy?
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OM with vascular insufficiency
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How does osteomyelitis with vascular insufficiency occur?
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Neuropathy! Pt unaware of tissue damage--peripheral vasc dz leads to poor perfusion which impairs normal inflamm resp and wound healing-->ENVIRONMENT CONDUCIVE TO ANAEROBES
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What route of osteomyelitis presents as chronic ulcers that do not heal?
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OM with vasc insuff
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What route of osteomyelitis is most commonly occurs in the foot bones?
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OM with vasc insuff
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Osteomyelitis with vascular insufficiency:
Mono/polymicrobial Microbe type |
Polymicrobial
Staph and strep staph or strep w/gram negs staph/strep, gram neg rods, and ANAEROBES AMPUTATION OFTEN NECESSARY!! |
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Erythrocyte sedimentation rate, C-reactive protein, and WBC count may be _____ in acute osteomyelitis.
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ELEVATED
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What imaging technique is most sensitive to osteomyelitis?
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MRI/CT Scan--they can reveal abscesses!
MRI is CHOICE for vertebral OM |
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What is the most common route of joint infections?
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Hematogenous
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What subset of patients have the highest incidence of acute bacterial arthritis?
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Patients with rheumatoid arthritis
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Where do joint infections tend to occur?
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MONOARTICULAR
Knee, hip, shoulders, wrist, ankle elbow |
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Joint infections:
Microbe Type by Age Treatment |
Staph aureus (older adults) and Neisseria gonorrhoeae (70% of males under 40)
Tx: antibx x 3weeks for staph a; drainage of joint |
