Osteomyelitis

Card Set Information

Author:
krissyhunter
ID:
262127
Filename:
Osteomyelitis
Updated:
2014-02-15 15:33:30
Tags:
Osteomyelitis NRO
Folders:
NRO
Description:
Osteomyelitis notes flashcards
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user krissyhunter on FreezingBlue Flashcards. What would you like to do?


  1. Definition
    Infection of the bone, typically affecting the cortex, medulla and periosteum
  2. Peak age
    • Typically children <12 years 
    • Adult onset usually due to compromised host resistance (e.g. immunosuppression, severe debilitation)
  3. Causative Organisms
    • S. aureus - 80% of identified cases
    • M. tuberculosis
    • E. coli - especially infants and the elderly
    • Salmonella spp - especially in patients with sickle cell disease
  4. Pathogenesis
    Gain access to the medullary cavity of bone via 2 main routes:

    • 1. Direct access: through an open wound, especially when #s are involved; also in post-op orthopaedic patients (especially joint replacement)
    • 2. Blood bourne spread: following bacteraemia from a focus of infection elsewhere
  5. Clinical Features
    • Abrupt onset of severe pain at the site of bone infection
    • Fever
    • Malaise
  6. Diagnostic investigations
    • Blood culture
    • Isotope Scan
  7. Management
    • Analgesia
    • Antibiotic therapy
    • Potential surgical drainage of abscesses
  8. Complications and sequelae:
    • Resolution
    • Pathological fracture
    • Adjacent sepsis
    • Chronicity
  9. Osteomyelitis Resolution
    With appropriate antibiotic therapy, ideally based on blood cultures or aspiration material
  10. Complications: pathological fracture
    Purulent acute inflammatory exudate formed in closed compartment of the marrow cavity --> compression of vessels --> necrosis of medullary bone and trabeculae --> increased predisposition to fractures
  11. Complications: Adjacent sepsis
    Destruction of cortical bone --> discharge of pus into extraosseuous CT --> infection my track through to skin surface and cause a discharging fistula

    • Malignant osteomyelitis - spreads to other bones
    • Septic arthritis: spreads to neighbouring joints
  12. Complications Chronicity
    • Organisms remain viable within the marrow cavity for many years
    • Leads to extensive bone destruction, marrow fibrosis and recurrent focal suppuration (Brodie's abscess)
    • Reactive new bone formation, particularly around inflamed periosteum leads to a thickened and abnormally shaped bone
    • Growth disturbace may occur if the physis is damaged in children

What would you like to do?

Home > Flashcards > Print Preview