Learning objectives
To review the spectrum of imaging findings of osteomyelitis in different radiologic modalities and correlate them with surgical findings.
To discuss the differential diagnosis and invasive treatment options available for osteomyelitis,
also showing their radiologic features.
Background
Osteomyelitis is defined as bone inflammation,
usually caused by pyogenic infection.
It is often a difficult-to-treat condition,
associated with considerable morbidity and important health care costs.
Osteomyelitis can occur in every age,
although it has a two-peak incidence,
one infantile,
in children before 5 years of age and,
another, in adults older than 50 years of age.
Its incidence is increasing in developing countries,
since the incidence of predisposal conditions such as diabetes mellitus is also raising.
Staphylococcus aureus is the most common causative agent,...
Findings and procedure details
Imaging findings of osteomyelitis
-Conventional radiography
Conventional radiography should be the first imaging exam requested since it may show some osteomyelitis features and can also exclude other diagnosis such as fractures or bone tumors.
However,
it has low sensitivity and radiologic findings only appear one to three weeks after the beginning of the infection.
Initially,
the imaging features are subtle.
Then radiography may show a wide-range of findings,
such as soft-tissue edema,
osteopenia,
impaired trabecular arrangement,
lytic lesions,
endosteal scalloping,
periosteal reaction and new bone...
Conclusion
Early detection is the key to a successful management of osteomyelitis.
Imaging is of extreme importance in the diagnosis of this condition,
so radiologists must be familiarized with its features.
MRI is the best technique,
by revealing marrow edema,
although other modalities are also useful.
However,
the diagnosis may be sometimes challenging,
as many lesions may mimic osteomyelitis.
References
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