Upon completion of the chapter, the reader will be able to
- 1. Compare the epidemiology of osteomyelitis when categorized by the mechanism of the organism reaching the bone.
- 2. Differentiate the characteristics of infectious arthritis.
- 3. Contrast the most common characteristics of hematogenous osteomyelitis.
- 4. Compare the pathophysiology of osteomyelitis by age group.
- 5. Select the most frequent organisms causing hematogenous osteomyelitis.
- 6. Contrast the most common characteristics of contiguous-spread osteomyelitis.
- 7. Discuss the organism sources of infectious arthritis.
- 8. Differentiate the risk factors for developing adult infectious arthritis.
- 9. Compare the etiologies of adult infectious arthritis subgroups.
- 10. Design a laboratory monitoring strategy for bone and joint infections.
- 11. Contrast the usefulness of culture sites with bone and joint infections.
- 12. Choose the preferred duration of therapy for patients with bone and joint infections.
- 13. Discuss the patient selection characteristics for oral antibiotic regimens treating osteomyelitis.
- 14. Critique the use of oral fluoroquinolones in the treatment of bone and joint infections.
- 15. Construct an empiric antibiotic regimen for different patient categories with bone or joint infections.
Bone and joint infections are composed of two disease processes known, respectively, as osteomyelitis and septic or infectious arthritis. They are unique and separate infectious entities with different signs and symptoms and infecting organisms. Despite advances in therapy, these infections continue to cause significant morbidity from residual damage and chronic recurring infections. Emphasis on initiating antibiotic therapy as soon as possible is important in reducing long-term complications.
Osteomyelitis generally is an uncommon disease. One classic publication reported that 247 patients had osteomyelitis in a prominent American teaching hospital during a 4-year period.1 Acute osteomyelitis ...