Pathophysiology

  • Infection of the bone
    • Adults - Usually contiguous spread
    • Children - Typically haematogenous spread
  • Most common cause: Staphylococcus aureus
  • Sickle cell patients - salmonella is the most common cause 

Management

  • Investigation:
    • X-ray is often first port of call - soft tissue swelling, periosteal reaction and cortical destruction
    • MRI is considered gold standard (sensitivity 90%)
  • Antibiotics:
    • Flucloxacillin (clindamycin if pen all) - usually for 6 weeks minimum