Crashing Patient

  • Home
  • EMCrit Blog
  • Index
  • Contact
You are here: Home / 09. Medical/Surgical / Bone and Joint Infections

Bone and Joint Infections

July 14, 2011 by CrashMaster

 

 

 

 

Osteomyelitis

Hematogenous, continuous, vascular disease, chronic

Staph Aureus is the #1 cause

Neonates-Group B Step, Kids-H Flu, Sex-gonorrhea, Elderly-gram neg, sicklers-salmonella

Puncture through shoes-pseudomonas (also prostheses and IVDA), animal bites pasteurella

 

Pain over bone, +ESR, 90% of Xrays positve after 1 month.  (lucent areas of bone or periosteal rxn)

Bone Scan-3 phases.  Technetium. Predilection for areas of increased osteoblastic activity. 1.  60 Seconds-angiogram 2.  15 min-areas of blood pooling 3.  2-4 hours-Inflammation Osteo is positive in all three phases

Can increase sensitivity with Indium 111 scan (WBC scan)

Rx:  2 to 4 weeks abx

 

Systematic Review of labs for osteo, white count useless, combination of ESR and CRP may be helpful. Normal ESR or CRP <5 mg/L seems to indicate negative unless high suspicion

Back to top  

Septic Arthritis

 

 

|      |      |

Share this:

  • Print
Back to top

Filed Under: 09. Medical/Surgical

Section Index

  • Osteomyelitis
  • Septic Arthritis

Creative Commons License 2012. This site represents the opinions of Crashing Patient LLC. See here for full disclaimer.

© 2021 ·