Bone Appétit
This is the most common bacterial pathogen causing osteomyelitis.
What is Staphylococcus aureus?
This complication can result when osteomyelitis spreads to a joint.
What is septic arthritis?
This imaging modality is most sensitive for early detection of osteomyelitis.
What is MRI?
Tapering chronic opioid therapy is essential to prevent this syndrome from developing when medication is stopped.
What is opioid withdrawal syndrome?
Absent or diminished stimulation of μ-opioid receptors → ↑ norepinephrine levels → OWS
Patients identified with IVDU should also be screened for these 3 infectious diseases.
What are HIV, hepatitis B, and hepatitis C?
This is a common presenting symptom associated with vertebral osteomyelitis, while fever may be absent.
What is insidious back pain?
Osteomyelitis in IV drug users most commonly affects this part of the skeleton due to rich blood supply.
What is the vertebrae?
When blood cultures are negative in suspected vertebral osteomyelitis, this diagnostic step is indicated.
What is an image-guided biopsy?
This long-acting opioid agonist is commonly used to manage opioid withdrawal symptoms.
What is methadone?
Urine drug test opioid assays can generate false-positive results because of cross-reactivity with this antibiotic.
What is rifampin?
Systemic symptoms (fatigue, fever, chills, malaise) are more likely to occur in this form of osteomyelitis.
What is acute ostemyelitis?
Children usually develop osteomyelitis through this route of infection.
What is hematogenous spread?
In cases of spinal infection with neurologic deficits or instability, this specialty should be consulted urgently.
What is neurosurgery?
This long-acting partial opioid agonist with high receptor affinity has a risk of precipitating withdrawal symptoms.
What is buprenorphine?
This screening tool contains the following question:
"How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?”
What is the National Institute on Drug Abuse (NIDA) quick screen?
Osteomyelitis associated with prosthetic devices often involves this type of bacteria, besides S. aureus.
What are coagulase-negative staphylococci (Staphylococcus epidermidis)?
The three routes of infection leading to osteomyelitis.
What are hematogenous spread, contiguous spread, and direct inoculation (trauma or surgery)?
X-rays show osteomyelitic changes after infection has been present for this amount of time.
What is 2 weeks?
This rescue medication should be considered for co-prescription in high-risk patients to reverse overdose.
What is naloxone?
An approach to the treatment of opioid use disorder or alcohol use disorder that combines counseling with pharmacological and behavioral therapy, tailored to each patient's needs.
What is medication-assisted treatment (MAT)?
These risk factors increase the likelihood of osteomyelitis (at least 3).
What are poor tissue perfusion, open fractures, severe soft tissue injury, immunosuppression, systemic diseases (e.g., diabetes mellitus, atherosclerosis), IV drug use?
In chronic osteomyelitis, this is a necrotic bone fragment that has become detached from the original bone and serves as a nidus for persistent infection.
What is sequestrum?
Initial treatment of osteomyelitis includes this when signs of sepsis or rapid progression are present, but should be tailored after culture results.
What is empiric antibiotic treatment (IV vancomycin + 3rd or 4th generation cephalosporin)?
Opioid withdrawal is generally uncomfortable but not fatal unless these complications are left untreated.
What are severe dehydration and electrolyte disturbances?
These are social factors that can predispose to IV drug use (at least 4).
What are childhood trauma, poverty, unemployment, unstable living situation, co-occurring psychiatric disorders, high availability of drugs, limited access to treatment services?