Question 1

A 3-year-old child has marked pain in one leg localized to the upper tibia with refusal to bear weight. The child has a high fever and a toxic appearance. Which type of osteomyelitis is most likely?&#10;A) Chronic osteomyelitis&#10;B) Hematogenous osteomyelitis&#10;C) Osteomyelitis from a contiguous focus&#10;D) Peripheral vascular disease osteomyelitis

Accepted Answer

The symptoms described are consistent with hematogenous osteomyelitis, which occurs when bacteria spread to bone through the bloodstream. It often presents with high fever, toxicity, and localized bone pain. Chronic osteomyelitis is a more long-standing infection, usually with a draining sinus tract. Osteomyelitis from a contiguous focus results from infection spreading from nearby soft tissue or bone, and peripheral vascular disease osteomyelitis occurs as a complication of poor blood flow to the affected bone.

Question 2

A 50-year-old patient with diabetes mellitus has a low-grade fever and pain on one foot. The provider notes erythema and swelling at the site along with several superficial skin ulcers without necrosis and suspects osteomyelitis. Which type of diagnostic study will the provider order?

A) Biopsy of bone or debridement cultures
B) Blood cultures and serologic markers of inflammation
C) Magnetic resonance imaging of the foot
D) Plain radiograph of the foot

D

Accepted Answer

D

Question 3

A patient has osteomyelitis related to vascular insufficiency. Which initial consultation is necessary?&#10;A) Infectious disease consultation&#10;B) Neurosurgical consultation&#10;C) Surgical consultation&#10;D) Wound care specialist consultation

Accepted Answer

A surgical consultation is necessary to assess the need for debridement or revascularization to address the underlying vascular insufficiency contributing to the osteomyelitis.

Deck 166: Osteomyelitis