14578764
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
over 5 years ago
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| Question | Answer |
| 1. TRUE/FALSE? A. Septic arthritis occurs most commonly in adolescents. | False. Septic arthritis is most common in the first two years of life as opposed to osteomyelitis which has a more or less even distribution across childhood and adolescence. |
| 1. TRUE/FALSE? B. Osteomyelitis is more common in adults than in children. | False. Adults rarely get haematogenous osteomyelitis in contrast to children who are predisposed to it owing to their vascular anatomy, predisposition to trauma and cellular anatomy. |
| 1. TRUE/FALSE? C. The commonest organism causing osteomyelitis or septic arthritis is Staphylococcus aureus. | True |
| 2. TRUE/FALSE? A. The investigation of choice in suspected osteomyelitis or septic arthritis is x-ray. | False. X-rays are usually normal in the initial stages of infection in osteomyelitis and septic arthritis, up to the initial 10 days or so. In osteomyelitis, bone scans are useful in determining the focus of infection. USS are helpful in localising fluid collections in septic arthritis however MCS of joint fluid is required to confirm a diagnosis of septic arthritis. USS not helpful in differentiating between the trandudative fluid seen in reactive arthritis as opposed to the exudative fluid (pus) seen in septic arthritis. |
| 2. TRUE/FALSE? B. Point tenderness is a cardinal sign of bone infection. | True. Always investigate for underlying pathology. |
| 2. TRUE/FALSE? C. Treatment of osteomyelitis involves rest and intravenous antibiotics. | True. The initial treatment of osteomyelitis is IV antibiotics and rest unless surgery is required for periosteal abscess or adjacent septic arthritis. |
| 3. TRUE/FALSE? A. The hip and shoulder are the joints most commonly affected by septic arthritis. | False. Most common joints are knee, hip and ankle. |
| 3. TRUE/FALSE? B. Treatment of septic arthritis involves rest and oral antibiotics. | False. Drainage (via aspiration, arthroscopy for knee/shoulder/ankle or arthrotomy for other joints) and IV antibiotics. |
| 3. TRUE/FALSE? C. Inability to weight bear in a child with an irritable hip is suggestive of serious pathology such as septic arthritis. | True. In a child who is unable to weight bear it’s important to rule out serious underlying pathology such as septic arthritis and osteomyelitis. Young children (preschoolers) with reactive arthritis may occasionally have severe pain and inability to weight bear in the early days but this should be a diagnosis of exclusion. Investigations should include blood work up (ESR, CRP, FBC and culture). Elevated inflammatory markers in a febrile unwell child support a diagnosis of septic arthritis/osteomyelitis. If the inflammatory markers are normal and the child does not appear unwell, is afebrile and there is passive range of movements at the joint then reactive arthritis is a possibility. Orthopaedic consultation should be sought and close follow up arranged. Hip pathology may present with knee or thigh pain, check range of motion at the hip as well as knee in cases presenting with knee pain. |
| 3. TRUE/FALSE? D. Neonates, especially if they have been in intensive care, are predisposed to multi focal osteomyelitis and septic arthritis and they have prominent focal signs. | False. Neonates have an immature immune system so there may be absent or minimal focal signs and normal inflammatory markers. |
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