Term
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Definition
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Term
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Definition
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Definition
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Term
| what is damaged in septic arthritis |
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Definition
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Term
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Definition
| spread from dental or GU infection |
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Term
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Definition
| trauma/lesion close to bone |
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Term
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Definition
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Term
| DJD of hip or knee, higher risk for infection following joint replacement |
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Definition
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Term
| kids with sickle cell disease get |
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Definition
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Term
| smoking and diabetes cause |
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Definition
| poor microvascular circulation to the extremities |
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Term
| post operation pts are have low serum conc of |
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Definition
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Term
| low _______, inc chance of infection |
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Definition
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Term
| most common infection responsible for ortho infections |
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Definition
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Term
| main virulence factor of S aureus |
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Definition
| Protein A (binds to Fc of IgG |
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Term
| other S aureus virulence factors besides Protein A |
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Definition
BIOFILM
polysacharide capsule that inhibits phagocytosis |
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Term
| aggragation of microbe colonies embedded within a glycocalyxmatrix |
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Definition
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Term
| rises within first 2 days of infection |
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Definition
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Term
| rises within first 6hrs of infection |
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Definition
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Term
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Definition
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Term
| infection can show up as __________ on a radiograph |
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Definition
swelling
loss of tissue planes
bony abnormalities (bone loss) |
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Term
| _________ bone matrix must be lost to show lytic area on xray |
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Definition
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Term
| detects inflammatory changes and rxn in the boneto infection within 48hrs of clinical onset |
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Definition
| Tech 99m phosphate (bone scan) |
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Term
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Definition
Flow phase (blood flow)
Equilibrium phase (extracellular space)
Delayed phase (osteoblastic activity) |
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Term
| Cellulitis is seen in which phase of 3phase bone scan? |
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Definition
| Flow and equilibrium phases |
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Term
| Osteomyelitis is seen in which phase of 3phase bone scan? |
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Definition
| all phases but mostly Delayed phase |
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Term
| DJD is seen in which phase of 3phase bone scan? |
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Definition
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Term
| Remove WBCs from body, Tag WBCs with marker, inj back in body and scan body at 2, 4, and 24hrs |
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Definition
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Term
| Can see infection better on T1 or T2? |
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Definition
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Term
| good for monitoring efficacy of abx tx |
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Definition
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Term
| dx sequence to osteomyelitis |
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Definition
xrays
3 phase bone scan
MRI
gallium studies |
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Term
-most common in kids
-caused by bacteremia
-involves metaphysis of growing bones
-can erod cortex, causing subperiosteal abscess and eventually sequestra and chronic osteomyelitis |
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Definition
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Term
-slower blood flow in kids
-bridging arteries to epiphysis |
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Definition
| metaphyseal arteries in kids |
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Term
| Very sick kid <2yo, hurts to move, fluid in hip |
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Definition
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Term
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Definition
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Term
| pts on long term parenteral nutrition |
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Definition
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Term
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Definition
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Term
-Localized subacute osteomyelitis
-metaphyseal and epiphyseal involvement
-lytic lesion with rim of sclerotic bone
-often confuced with neoplasm
-dead necrotic center
-usu tibia |
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Definition
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Term
-dead bone with compromised soft tissue envelope
-avascular surrounding scar tissue renders abx ineffective
-foci contain purulence, infected granulation tissue (sequestrum)
-surgery
-6w IV abx followed by debridement
-has a Rim Sign on MRI
-located where there is greater blood supply |
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Definition
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Term
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Definition
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Term
a piece of dead bone that has become separated (during the process of necrosis) from normal bone
-haversion canals blocked and surrounded by thickened periosteum
-avascular (abx cannot penetrate) |
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Definition
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Term
-inc intramedullary pressure from inflammation
-periostreum becomes stripped from osteum leads to vascular thrombosis
-necrosis due to lack of blood supply |
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Definition
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Term
Bone formed below periosteum and surrounds sequestrum
-dense bone
-sinus tract - dead bone and pus can pass out of sequestrum)
-cannot penetrate w abx |
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Definition
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Term
| Excision of sequestered bone |
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Definition
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Term
Do not begin abx tx unless dx testing and specimens have been obtained
-surgery needed if no drainiage present
-biofilm and dead bone must be removed |
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Definition
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Term
-Hyperbaric O2 therapy
-External fixators
-Wound vac
-abx cement |
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Definition
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Term
| most common bug w septic arthritis |
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Definition
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Term
-Migratory polyarthritis
-Rash
-Tenosynovitis of dorsum of hand or foot |
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Definition
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Term
| most common septic arthritis bugs for immmunocompromised adults? |
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Definition
| Mycobacterium or fungal infections |
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Term
| IV Drug abusers can get (2) |
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Definition
Psuedomonas aeruginosa
Serratia marcescens |
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Term
-pain with passive joint motion
->80k with 75% PMNs = septic joint
-WBC >12k ; 40-60% PMN ; ESR>55 |
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Definition
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Term
| Collagen receptors have been found on |
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Definition
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Term
| destruction of articular cartilage results from degraadation of ground substanceby proteolytic enymes and loss of |
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Definition
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Term
| approach for knee aspiration |
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Definition
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Term
| use a scope to wash out puss from a joint with cephaloporin solution |
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Definition
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Term
IV abx
aspiration
arthroscopic lavage
arthrotomy
synovectomy |
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Definition
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Term
| most common ortho infection |
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Definition
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Term
| most common ortho infection in neonates |
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Definition
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Term
| most common ortho infections in kids <3 |
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Definition
S aureus
S pneumonia
S pyogenes |
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Term
| Polyarticular septic arthritis |
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Definition
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Term
| -sluggish circulation and dec phagocytosis allow bacterial innoculation in |
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Definition
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Term
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Definition
| volkmans canals to periosteum |
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Term
| what vessels traverse the physis |
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Definition
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Term
| any child with a fever and limb pain for 3d should be evaluated for |
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Definition
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Term
-3-8yo
-acutely iritable hip
-clinical presentation may be indistinguishable from septic arthritis
-if fever, inability to bear weight, ESR >40mm/h, and WBC>12k - 99.6%dx |
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Definition
| Transient Synovitis of the hip |
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Term
Inflammatory arthritis
JRA
Post strep arthritis
viral synovitis
Rheumatic fever
Transient synovitis |
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Definition
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Term
-affects every organ system
-50% with osseus involvement have pulmonary involvement
-intervertebral disc |
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Definition
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Term
-chronic arthralgias
-charcot neuroarthropathy
-VDRL, RPR for work up
-tx penicillin benzathine |
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Definition
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Term
| joint that is arthritic and deformed DJD-like |
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Definition
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Term
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Definition
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Term
| Type I Necrotising Fasciitis |
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Definition
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Term
| Type II Necrotising Fasciitis |
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Definition
| Monomicrobial (S pyogenes) |
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Term
| Type III Necrotisin Fasciitis |
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Definition
| Gas gangrene (clostridial) |
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Term
-30% pts die
-Septic shock
-Grp A strep
-50% of cases occur in young and prev healthy ppl |
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Definition
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Term
| -Hematogenous infection of disk and vertebral body |
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Definition
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Term
| most common Diskitis organism |
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Definition
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Term
| presents with severe pain, limited motion, narrowing of disk space |
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Definition
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Term
| risk for infected total joint prosthesis |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| remove prosthesis, leave it out and put in a spacer with abx |
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Definition
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Term
| One or Two stage revision for infected prosthesis in old weak pt? |
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Definition
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Term
| inc risk of infection if >____ppl in OR |
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Definition
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Term
double glove
limit traffic
cold temp
low humidity
open OR right before
edema control
filtered air
positive pressure (laminar air flow)
Space suits |
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Definition
| infection prophylaxis in the OR |
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Term
-multisystem spirochetal disorder
-transmit by tick bite |
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Definition
| Lyme Disease (Borrelia burdorferi) |
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Term
1)eyrthema migrans - local skin lesion
2)disseminated disease - neuro/cardiac, meningoencephalitis
3) MSK sx - monoarthritis, arthralgia |
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Definition
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Term
| needs to be tx as a bite wound |
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Definition
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Term
-Aerobes (Eikenella corrudens, Corynebacterium, Staph)
-Anaerobes (Bacteroides, Peptostreptocous) |
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Definition
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Term
| first line against human bite |
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Definition
| Augmentin (oral) 875mg bid |
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Term
| human bite tx if penicillin allergy |
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Definition
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Term
| human bite tx if admitted to hospital |
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Definition
| IV Rocephin (2nd gen Cephalosporin) 1gm qd |
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Term
| when to admit a bite victim |
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Definition
Hand injury
face injury
non-compliance
failure to improve after initial management |
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Term
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Definition
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Term
| bites associated with crush injuries |
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Definition
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Term
| bites associated with rabies |
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Definition
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Term
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Definition
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Term
Necrotizing Arachonoidism
tissue necrosis
eschar |
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Definition
| Brown Recluse Spider bite |
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