osteomyelitis

Question 1

Haematogenous osteomyelitis: is more common in

Answer 1

children

Question 2

Haematogenous osteomyelitis:

1. In children– affect ______ of the ______skeleton
2. In adults– affect vertebrae, symphysis pubis, ______ & ______ joints

Answer 2

1. In children– affect long bones of the appendicular skeleton
2. In adults– affect vertebrae, symphysis pubis, sternoclavicular & sacroiliac joints

Question 3

Manifestations of haematogenous osteomyelitis

Answer 3

• bacteremia
• pain on movement of the affected extremity
• loss of movement
• local tenderness

Question 4

Chronic osteomyelitis: is more common in

Answer 4

adults

Question 5

Chronic osteomyelitis may appear

Answer 5

after a few yrs, spontaneously, after a minor trauma or when resistance is lowered

Question 6

Tuberculosis osteomyelitis is caused by

Answer 6

mycobacterium tuberculosis

Question 7

Tuberculosis osteomyelitis: _____ is the most common site

Answer 7

spine (pott’s disease)

Question 8

Tuberculosis osteomyelitis manifestations

Answer 8

• pain
• immobility
• muscle atrophy
• joint swelling
• mild fever
• leukocytosis

Question 9

is a bone infection caused by:

Answer 9

bacteria (S.aureus) & fungi

Question 10

Management of haematogenous osteomyelitis

Answer 10

• Antimicrobial agents (IV then oral)– ceftriaxone, vancomycin
• Supportive measures (pain relief, rest)
• May be a need for debridement/ surgical drainage

Question 11

In continuous spread: bacteria spread from

Answer 11

adjacent soft tissue

Question 12

Risks factors of continuous spread/direct penetration

Answer 12

pts with vascular insufficiency (e.g. skin lesion, chronic/ ischemic foot disease usually from poorly controlled diabetes)

Question 13

Manifestations of continuous spread/direct penetration

Answer 13

• Persistent/recurrent fever
• Increased pain at operative site
• Poor incisional healing

Question 14

Diagnosis of continuous spread/direct penetration

Answer 14

• Culture & sensitivity

- Conventional radiology, nuclear imaging, CT scans, MRI

Question 15

Management of continuous spread/direct penetration

Answer 15

Antibiotics

Surgical interventions

Question 16

Chronic is a result of

Answer 16

delayed/insufficient treatment of haematogenous osteomyelitis

Question 17

Tuberculosis osteomyelitis: M.tuberculosis spreads from

Answer 17

lungs/lymph nodes

Question 18

Management of Tuberculosis osteomyelitis

Answer 18

• 3-4 antibiotics therapy (RIPE)

- Conservative treatment (earlier/milder cases)