Commonest cause of acute osteomyelitis:
Correct Answer: Hematogenous route
Description: Ans: D (Hematogenous) "Acute osteomyelitis: This can be primary (haemotogenous) or secondary(following an open fracture or bone operation). Haematogenous osteomyelitis is the commonest & is often seen in childrenStaphylococcus aureus is the commonest causa tive organism, others are streptococcus & pneumococcusMaheshwari 3rd/157ACUTE OSTEOMYELITISAcute osteomyelitis is almost invariably a disease of children. The causal organism is usually Staphylococcus aureus, less often one of the other gram-positive cocci, such as streptococcus pyogenes or S. pneumonia.Patients with sickle-cell disease are prone to infection by salmonellagOn X-ray, the earliest sign to appear is a periosteal new bone deposition (Periosteal reaction) at the metaphysis . It takes about 7-10 days to appear. Plain X-ray is unable to detect sequestra or sclerotic new bone for many weeks.Bone scan with TC9 is earliest positive within 24 hours of onset of symptoms.In acute osteomyelitis, metaphyseal infection is usual, the growth disc acts as a barrier to spread.."All types of organisms, including viruses, parasites, fungi, and bacteria, can produce osteomyelitis, but infections caused by certain pyogenic bacteria and mycobacteria are the most common"- Robbins 8th/1221-23"Pyogenic osteomyelitis is almost always caused by bacteria. Organisms may reach the bone by (1) hematogenous spread, (2) extension from a contiguous site, and (3) direct implantation. Most cases of osteomyelitis are hematogenous in origin and develop in the long bones or vertebral bodies in otherwise healthy individuals-Stapfty/ococcus aureus is responsible for 80% to 90% of the cases of pyogenic osteomyelitis in which an organism is recovered."- Robbins 8th/1221-23
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Orthopaedics
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