Good Morning and Welcome Applicants!
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Transcript of Good Morning and Welcome Applicants!
Good Morning and Welcome Applicants!
December 2, 2010
Septic ArthritisOsteomyelitis
Septic Arthritis• Most common organism?
• Staph Aureus• Presentation?
• Acute• Monoarthritis• Erythema• Warmth• Swelling• Intense pain on movement• Fever – 70%
Septic Arthritis• Definitive Diagnostic Test?
• Joint fluid anaylsis and culture• Other labs or studies?
• CBC• ESR/CRP• US• CT/MRI
Septic Arthritis• Emergency?
• Outcome depends of timing of diagnosis, initiation of antibiotics, adequacy of drainage, virulence and host factors
Osteomyelitis• Presentation
• Fever• Localized pain• Erythema• Swelling• Pinpoint tenderness• Decreased ROM
Osteomyelitis• Diagnosis?
• Bone scan• MRI• Bone Culture
• Other labs?• WBC• ESR/CRP• Blood culture – 60%• Bone culture – 80%• Plain films
Transient or Toxic Synovitis
• Emergency?• Benign, self-limited
• Causes?• Acute or post infection• Trauma
• 30% of all nontraumatic limps
Transient Synovitis• Presentation?
• Limp• Painful hip• Afebrile or low-grade• Otherwise appears well• Mild restriction of ROM
Transient Synovitis• Diagnosis?
• Exclude septic arthritis and osteo• Four predictors associated with septic
arthritis• History of fever• Inability to bear weight• ESR >40• WBC >12
Transient Synovitis• Treatment?
• Rest• Anti-inflammatory
• Most children do very well