Infections of Bone

Question 1

Osteomyelitis is?

Answer 1

An infection of bone. usually either blood borne or after an operation or open fracture.
Most commonly Staph aureus or salmonella in sickle cell patients.

Question 2

Risk factors for Osteomyelitis?

Answer 2

Diabetes. Sickle cell anaemia
IV drug user
HIV or drug immunosuppression
Alcohol excess

Question 3

Investigations for Osteomyelitis?

Answer 3

MRI is the modality of choice with a sensitivity of 90-100%

Question 4

Managment of Osteomyelitis?

Answer 4

Generally horrible once established.

Give flucloxacillin for 6wks (or longer) or clindamycin if allergic. May require surgical debridement

Question 5

Presentation of Osteomyelitis

Answer 5

Usually presents with deep seated bone pain +- septic arthritis. WCC and inflammatory markers may be normal

Question 6

Where do bones get infected?

Answer 6

Generally it affects the metaphysis of the bone because blood flow is slower.
In children under 2yrs it can spread to the epiphysis (and from here into the joint, which is why septic arthritis is commoner in younger children .