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pedia - bone

med22

QuestionAnswer
What is the most common age group and gender affected by Osteomyelitis in children? Children 3–12 years of age, affecting males twice as frequently as females.
What is the most common location for Osteomyelitis in long bones of children? The metaphysis of long bones.
What is the most common cause of Osteomyelitis in children, and what is the pathophysiology? Acute hematogenous osteomyelitis, which evolves secondary to bacteremia (blood-borne infection).
In children with Sickle Cell Disease (SCD), where does Osteomyelitis typically occur? In the diaphyseal portion of the long bones (instead of the metaphysis).
What is the most common causative organism for Osteomyelitis across all pediatric age groups? Staphylococcus aureus (S. aureus).
What is the most common causative organism for Osteomyelitis in children with Sickle Cell Disease (SCD)? Salmonella species.
Which two lab markers are most indicative of inflammation/infection in Osteomyelitis? Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP), both of which are usually elevated.
What is the gold standard for diagnosing Osteomyelitis? Bone culture (obtained via needle aspiration or open biopsy).
Which imaging modality is the most sensitive and specific for early diagnosis of Osteomyelitis? Magnetic Resonance Imaging (MRI).
What is the general treatment plan for Acute Hematogenous Osteomyelitis? Initial IV antibiotics for 3–6 weeks, followed by switching to oral antibiotics for a total duration of 4–6 weeks or until the CRP/ESR normalize.
What are the two most common sites affected by Septic Arthritis in pediatrics? Knee and Hip.
What is the classic clinical presentation of Septic Arthritis? Fever, refusal to use or bear weight on the affected limb, swelling of the joint, and local heat.
What is the initial diagnostic procedure of choice for evaluating a suspected joint effusion in Septic Arthritis? Ultrasound (to confirm and localize the fluid/effusion).
What are the two defining findings in the Synovial Fluid analysis from arthrocentesis that confirm Septic Arthritis? WBC count $\ge 50,000$ cells/mm$^3$ and a positive Gram stain/Culture.
What is the critical management step for Suppurative Arthritis of the Hip or Shoulder? Prompt surgical drainage (due to high risk of avascular necrosis and growth plate damage).
What is the initial antibiotic therapy for children 3 months to 5 years old being treated for Septic Arthritis? Antibiotics with activity against S. aureus, such as Clindamycin or Vancomycin (if MRSA is suspected).
Why does septic arthritis of the hip and shoulder carry a high risk of complications? They carry the highest incidence of loss of joint function resulting from damage to the articular surface (avascular necrosis) and places the epiphyseal growth plate at high risk for growth abnormalities.
Created by: MeanHeem
 

 



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