Phys Clinical Cases · infectious
Bone AND Joint Infections — DCE Clinical Case
DCE long-case and short-case station for Bone AND Joint Infections.
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FRACP DCEMRCP PACES
Prompt
DCE long-case and short-case station for Bone AND Joint Infections.
Bone AND Joint Infections — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Bone AND Joint Infections. [1]
Presenting complaint: Subacute or acute symptoms referable to Bone AND Joint Infections, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
References6ShowHide
- [1]Berbari EF, Kanj SS, Kowalski TJ, et al. 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis, 2015.PMID 26229122
- [2]Osmon DR, Berbari EF, Berendt AR, et al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis, 2013.PMID 23223583
- [3]Mathews CJ, Weston VC, Jones A, et al. Bacterial septic arthritis in adults. Lancet, 2010.PMID 20206778
- [4]Lipsky BA, Berendt AR, Cornia PB, et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis, 2012.PMID 22619242
- [5]Li HK, Rombach I, Zambellas R, et al. Oral versus Intravenous Antibiotics for Bone and Joint Infection. N Engl J Med, 2019.PMID 30699315
- [6]Mitrovic S, Delplanque M, Ea HK, Frémond ML, et al. Club Rhumatismes et Inflammation guidelines for anti-interleukin-1 therapy: 2026 update Joint Bone Spine, 2026.PMID 42276158