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18 Cards in this Set
- Front
- Back
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• What is osteomyelitis?
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o Infection of bone tissue
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• What are the three mechanisms by which a bone may become infected?
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o 1) Direct inoculation (e.g. open fracture)
o 2) Spread from adjacent infected tissue o 3) Hematogenous spread |
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• What is the classic presentation of osteomyelitis?
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o Dull pain over the infected site that is independent of movement (i.e. it hurts even when they're not moving it)
o Pain may be accompanied by systemic symptoms such as fever and malaise. |
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• What affect does movement have on the pain of osteomyelitis?
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o None, as the pain of osteomyelitis is independent of movement.
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• Osteomyelitis due to hematogenous seeding most frequently occurs in which three groups of people?
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o 1) Children
o 2) The elderly o 3) IV drug users |
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• Which bones are most frequently infected in adult hematogenous osteomyelitis?
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o Vertebral bodies
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• What is the most common site of hematogenous osteomyelitis in children?
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o The metaphyses of long bones, particularly of the tibia and femur.
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• What is the most common causative organism of hematogenous osteomyelitis in adults?
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o S. aureus
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• What are the most common causative organism of hematogenous osteomyelitis in children?
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o S. agalactiae
o S. aureus o E. coli |
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• Which organism do you have to watch out for in hematogenous osteomyelitis in IV drug users?
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o Pseudomonas aeruginosa
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• How should you investigate suspected osteomyelitis?
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o Imaging:
• Plain film radiographs to start o Labwork: • CBC with differential, ESR, CRP o Microbiology: • Blood cultures, tissue culture o In order to make the definitive diagnosis, a sample from the suspected bone must be surgically obtained and cultured. |
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• True or false: in osteomyelitis the peripheral WBC count is usually normal.
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o True.
o ESR and CRP are typically elevated but the WBC count is often within normal limits. |
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• Name 3 x-ray findings associated with osteomyelitis.
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o Areas of decalcification (lytic lesions)
o Sequestra o Periosteal reaction |
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• How do chronically infected vertebral bodies characteristically appear on plain film?
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o The classic description is “moth-eaten.”
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• How can osteomyelitis of the vertebral bodies be distinguished from metastatic bone lesions?
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o In osteomyelitis, the infection almost invariably involves two adjacent vertebral bodies and the disc space.
o Most neoplastic processes involve a single vertebral body and do not extend across the disc space. |
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• What is the treatment of osteomyelitis?
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o Long-term (>6 weeks) systemic antibiotics
o Surgical decortication and drainage if necessary |
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• How long is the minimum pharmacologic treatment of osteomyelitis?
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o At least 6 weeks.
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• What are the indications for surgery in vertebral osteomyelitis?
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o Failure of medical management
o Formation of soft-tissue abscesses o Signs of spinal cord progression (monitor neurological function) |
