Bone & Joint Infections

Topics in this chapter

• Osteomyelitis Types and Classification
• Microbiology and Risk Factors
• Anatomy and Spread of Infection
• Imaging and Diagnosis
• Septic Arthritis
• Tuberculous Bone and Joint Infection
• Management of Bone and Joint Infections

Practice questions

1. Question 1Q-8CB730

   A 7-year-old boy presents with high-grade fever, severe pain, and inability to bear weight on his right lower limb for 3 days. On examination, there is local warmth, tenderness, and swelling over the right proximal tibia. Radiographs of the tibia are normal. Which of the following is the most sensitive imaging modality for early diagnosis of acute osteomyelitis in this patient?

   1. A.Plain radiography
   2. B.Magnetic Resonance Imaging (MRI)
   3. C.Technetium-99m bone scan
   4. D.Computed Tomography (CT)
   See the answer and solution
2. Question 2Q-7A9049

   What is the most common causative organism of acute hematogenous osteomyelitis in children across all age groups?

   1. A.Streptococcus pyogenes
   2. B.Pseudomonas aeruginosa
   3. C.Staphylococcus aureus
   4. D.Kingella kingae
   See the answer and solution
3. Question 3Q-DAD11A

   A 10-year-old boy is diagnosed with acute osteomyelitis of the distal femur. The metaphyseal location of hematogenous osteomyelitis in children is primarily attributed to which of the following anatomical features?

   1. A.High blood flow with sluggish, looping end-arteries and absence of anastomoses
   2. B.Continuous capillary network crossing the physis into the epiphysis
   3. C.Thick cortical bone providing a rich nutrient supply
   4. D.Direct communication between the joint space and the medullary cavity
   See the answer and solution
4. Question 4Q-2A47BB

   A 4-year-old child presents with an acute septic arthritis of the right hip joint, characterized by a painful, held-in-flexion, abduction, and external rotation posture. Which of the following is the most urgent and appropriate initial management?

   1. A.Immediate intravenous broad-spectrum antibiotics and observation for 48 hours
   2. B.Urgent surgical arthrotomy or arthroscopic washout combined with IV antibiotics
   3. C.Skin traction alone with oral anti-inflammatory medications
   4. D.Aspiration of the joint in the outpatient clinic and discharge on oral antibiotics
   See the answer and solution
5. Question 5Q-35C5E5

   In chronic osteomyelitis, what is the term used to describe a piece of necrotic, infected bone that has become separated from the living bone?

   1. A.Involucrum
   2. B.Sequestrum
   3. C.Cloaca
   4. D.Brodie abscess
   See the answer and solution