Infection · UKMLA & AKT

Osteomyelitis

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise osteomyelitis — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Staphylococcus aureus - most common cause across ALL age groups; expresses surface adhesins (fibronectin-binding proteins) that bind directly to bone matrix, giving it high skeletal affinity
  • Haematogenous spread from distant source (UTI, indwelling catheter, skin) most commonly seeds bone with S. aureus - even when the primary source is urinary
  • *Escherichia coli* - common UTI pathogen but does NOT express bone-binding receptors; unlikely cause of osteomyelitis despite urinary source
  • *Neisseria gonorrhoeae* - associated with septic arthritis in young adults, NOT osteomyelitis
  • *Haemophilus influenzae* and *Mycobacteria* - rare causes; far less common than S. aureus

Even when the apparent source is a UTI or urinary catheter, S. aureus (a skin commensal colonising the catheter) is the most likely bone pathogen - not the Gram-negative urinary organism.

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