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15 Cards in this Set
- Front
- Back
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organisms in hematogenous osteomyelitis
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- SA most common, then strop
- H flu common before vaccine - sickle cell get salmonella - immunocomp get (-) |
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how do kids get hematogenous osteomyelitis?
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- by the nutrient artery
- channles have a blind end at the epiphyseal plate, and turn 180 so sluggish |
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how does hematogenous osteomyelitis spread in children?
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- to the metaphysis
- stops at epiphyseal plate - can spread in hip, shoulder, radial neck, distal fibula (not knee) |
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cloacae
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openings in involucrum, may allow escape of pus from sequestrum
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hematogenous osteomyelitis radiographs
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- not apparent for 8-12 days
- ealiest is molted areas of decreased density - then, involucrum over the next few weeks - once in chronic phase, opaque ares of bone surrounded by a lucent zone (exudate and granulation) |
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how can osteomyelitis best be looked at radiographically
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- radioisotope scanning w/
- technetium phosphate - Immediate, 5 minutes, 3 hours - False negatives and positives (Esp in Sicklers) - gallium - Time consuming- up to 2 days delay - False Negatives and Positives - Leukocyte-labeled Imaging - withdraw white cells - Label and reinject - Expensive and Time Consuming |
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most common areas of hematogenous osteomyelitis
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- distal femur
- prox tibia and humerus |
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Brodie abscess
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- forms when osteomyelitis is contained locally
- scar tissue and a rim of reactive bone surround the infection - its a cavity filled w/ pus that may become sterile |
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how do adults get hematogenous osteomyelitis?
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- they get it from GU surgeries through the pelvic plexus (batson's plexus) or IV drug users
- usually in vertebra, and can go do disks - if in long bones, can extend to next joint |
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how do you get exogenous osteomyelitis?
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- open fracture
- surgery w/ artifical joints (really bad if RA b/c immune system down) |
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how does path of exogenous osteomyelitis differ from hematogenous osteomyelitis
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- goes quickly from acute to chronic
- antibiotics frequently fail and you usually need extensive surgery, maybe even amputation - infection inhibits healing of the original fracture |
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what are the most common sites for spread of hematogenous osteomyelitis
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- skin
- URI - dental |
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what organisms cause infections arthritis?
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- SA most common (unless young, healthy, sexually active, then its N gon. )
- H flu in young kids (less so since vaccine) - S Epidermidis in prosthetic joints |
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infections arthritis radiology
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- capsular distention, then osteopenia
- narrowing of joint space - if late and in spine, ankylosis |
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infections arthritis dx
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- if N gon or H flu, use chocolate agar plates
- if low grade findings, do a fungal media - look for urate crystals - white cells above 50,000 and glucose if halved |
