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General
intermediate
X-Type

Osteomyelitis Pathophysiology - Acute, Chronic, and Biofilm

Musculoskeletal Infection

A 7-year-old boy presents with a 5-day history of progressive left knee pain, fever (39°C), and inability to weight-bear. He is systemically unwell. Blood tests show WCC 18.5 x 10⁹/L, CRP 185 mg/L, ESR 65 mm/hr. Plain radiographs appear normal. MRI reveals metaphyseal bone marrow oedema and periosteal elevation in the distal femur with a small subperiosteal abscess. Regarding the pathophysiology of acute haematogenous osteomyelitis:

Mark each as TRUE or FALSE

A

Haematogenous osteomyelitis typically affects the METAPHYSIS of long bones in children; the metaphys...

B

Once bacteria lodge in metaphyseal bone: initial INFLAMMATORY response occurs (cytokines, neutrophil...

C

Haematogenous osteomyelitis typically affects the DIAPHYSIS in children; the diaphyseal blood flow i...

D

Paediatric considerations: PHYSIS acts as a barrier to spread in children greater than 18 months (av...

E

Radiographic changes in acute osteomyelitis: soft tissue swelling visible at 3 days; PERIOSTEAL REAC...

Answer the questions to see explanations

Click T (True) or F (False) for each option