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15 Cards in this Set

  • Front
  • Back
organisms in hematogenous osteomyelitis
- SA most common, then strop
- H flu common before vaccine
- sickle cell get salmonella
- immunocomp get (-)
how do kids get hematogenous osteomyelitis?
- by the nutrient artery
- channles have a blind end at the epiphyseal plate, and turn 180 so sluggish
how does hematogenous osteomyelitis spread in children?
- to the metaphysis
- stops at epiphyseal plate
- can spread in hip, shoulder, radial neck, distal fibula (not knee)
openings in involucrum, may allow escape of pus from sequestrum
hematogenous osteomyelitis radiographs
- 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)
how can osteomyelitis best be looked at radiographically
- 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
most common areas of hematogenous osteomyelitis
- distal femur
- prox tibia and humerus
Brodie abscess
- 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
how do adults get hematogenous osteomyelitis?
- 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
how do you get exogenous osteomyelitis?
- open fracture
- surgery w/ artifical joints (really bad if RA b/c immune system down)
how does path of exogenous osteomyelitis differ from hematogenous osteomyelitis
- 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
what are the most common sites for spread of hematogenous osteomyelitis
- skin
- dental
what organisms cause infections arthritis?
- 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
infections arthritis radiology
- capsular distention, then osteopenia
- narrowing of joint space
- if late and in spine, ankylosis
infections arthritis dx
- 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