What is osteomyeltitis?
Infection of the bone
- progressive inflammatory destruction
- apposition of new bone
- extensive remodelling
What are the routes of infection?
Haematogenous spread
Direct inoculation
Direct spread from nearby infection
What are the common causative organisms?
Staph aureus
Group A strep
Enterobacter
What is a common organism in IVDUs?
Pseudomonas aeruginosa
What is a common organism in sickle cell patients?
Salmonella
What is the pathophysiology of osteomyelitis?
Pathogen settles in bone
Undergoes apoptosis and creates biofilm
Inflammation = subperiosteall reaction -> lifts periosteum from bone
Devitalises bone
What is a sequestrum?
Floating piece of bone
What is an involucrum?
Periosteal new bone
What is a cloaca?
Site of pus escape
Which part of the bone is effected in children?
Metaphysis
- rich blood supply
What are the risk factors for osteomyelitis?
Diabetes
Immunosuppression
Vascular disease
Trauma
What are the clinical features of osteomyelitis?
Severe pain
Systemic symptoms
- fever
Joint effusion
Swelling + erythema
What investigations are required for suspected osteomyelitis?
Bloods
- FBC
- U+Es
- CRP
Blood culture
Local culture
X-ray
MRI
How is osteomyelitis managed?
High dose IV abx
Analgesia
Surgery
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Open Fracture7
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Fractured Neck of Femur10
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Fractures14
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Acute Joint Pain4
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Back pain8
-
Osteoarthritis11
-
Compartment Syndrome6
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Shoulder Dislocation7
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Rotator Cuff Tear14
-
Radial Head Fracture5
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Carpal Tunnel Syndrome9
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Scaphoid Fracture6
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Cauda Equina8
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Tibial Plateau Fracture6
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Ankle Fracture8
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Plantar Fasciitis5
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Distal Radius Fracture10
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Necrotizing Fasciitis8
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Frozen Shoulder12
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Osteomyelitis14
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Bone Tumours38
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Salter-Harris Fractures15
