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18 Cards in this Set
- Front
- Back
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What is the x-ray appearance of osteomyelitis: initially? At 7 to 10 days?
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Initially: soft tissue swelling only
After 7 to 10 days: bone demineralization (eg., lucencies) or disk space narrowing |
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When does subperiosteal elevation show up on x-ray?
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At approximately 14 days
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What is the radiographic appearance at 6 months?
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Reactive bone
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What is the MRI appearance of osteomyelitis: T1? T1 with gadolinium? T2?
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T1: low intensity
T1 with gadolinium; high intensity T2: high intensity |
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What is the key treatment sequence of six steps for osteomyelitis in adults?
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Identify organism
Surgical resection Begin appropriate systemic or local antibiotics Stabilization (e.g., external fixator) Delayed closure (e.g., soft tissue;coverage) Bone graft as necessary |
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What are the two best means to identify the etiologic organism?
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Aspiration of multiple deep sites
Culture |
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ls a gram stain sufficient?
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No, gram stain is not sufficiently sensitive
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Should empiric antibiotic therapy be used for osteomyelitis in adults?
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No; treatment should be organism-specific
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What may inadequate or inappropriate antibiotic treatment lead to?
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Chronic osteomyelitis
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Subacute osteomyelitis is essentially what?
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Slowly developing osteomyelitis
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With subacute osteomyelitis, are white blood count (WBC) and blood cultures
generally valuable? |
No, these studies are often normal
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What three diagnostic tests are preferred?
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CRP/ESR
Radiographs Bone aspiration and culture |
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What are the two key imaging studies to visualize diskitis and vertebral osteomyelitis?
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MRI
Technetium and gallium bone scan |
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Is a biopsy generally necessary to identify the etiologic organism?
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Yes, must biopsy as in other cases of adult osteomyelitis
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What is the initial preferred treatment?
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Antibiotics if no epidural abscess or neurologic compromise
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What is the indication for surgical intervention?
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Failure of antibiotic therapy
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What are the two key imaging studies to visualize epidural abscesses?
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MRI
Contrast CT scan |
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Is a biopsy generally necessary?
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No, immediate operative intervention if neurologic deficit; antibiotic therapy
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