Acute Haematogenous Osteomyelitis – Board-Style Questions

What this deck covers

acute haematogenous osteomyelitis in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. The starting point
2. Which bone usually
3. What the pictures showed
4. A film that misleads
5. A limp with little to find
6. Pain in the foot
7. A long dull pain
8. More than one place
9. A child with sickle cells
10. Unusually severe illness
11. Finding the organism
12. More than antibiotics
13. Not getting better
14. Looking for the source
15. Alongside the drugs
16. Two kinds of bone
17. Years later
18. A sudden crack

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: The joint surface, which has no blood supply of its own at all and relies on fluid, The lower femur and the upper tibia, the two commonest sites, A tear of the muscle where it attaches to the thigh bone, Complete loss of the outline of the bone over its whole visible length here, The pelvis, where the examination is unremarkable and diagnosis is late, The ankle joint, which would swell visibly in front, A stress fracture from running, which would show a line, A vitamin deficiency affecting the growing ends of the bones, Salmonella, which causes bone infection far more often in this disease, An allergic reaction to the antibiotic he was started on, A urine sample, which will grow the same organism, Bed rest for a fortnight, with the antibiotic continued exactly as it is now, No improvement by the third day, which means a collection has formed, A sweat test, since recurrent infection suggests it.

Clinical pearls from this deck

• Bloodborne bacteria settle where the flow slows.
• Around the knee: the lower femur and upper tibia.
• Marrow oedema first, then pus under the periosteum.
• Layered new bone: infection and tumour both do this.
• Febrile limp with a normal leg: image the pelvis.
• Heel pain with fever and no wound: the calcaneus.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all MSK and orthopaedics case decks · pediatric reference values.