Describe and illustrate the different imaging findings of osteomyelitis in infants and children. Depict how imaging can have a crucial role in the diagnosis of osteomyelitis in the pediatric population and emphasize its usefulness in therapy guidance and intervention.

Osteomyelitis is an infection of bone, bone marrow and surrounding soft tissue. It is subdivided according to the time of onset and is classified in acute (<14 days), subacute (2-6 weeks) and chronic (>6 weeks).1,2 In children, the most frequent route of infection is hematogenous spread. Direct spread by penetration after trauma is less common, and typically occurs in older children, with S. aureus being the most frequent pathogen involved.3 The number of Methicillin-resistant S. aureus (MRSA) infections has increased in the recent past and...

Imaging features are variable, depending on the age of the patient, pathogenic agent, disease severity and imaging modality performed. It is always important to describe the location of the infection, if there is a single focus or multiple foci of infection, as well as the presence of drainable collections. Signs of poor prognosis are also crucial to depict, more importantly the presence of extensive subperiosteal abscess or bone marrow ischemia. 5 Conventional radiography should be the initial modality to evaluate bone abnormalities. Bone disease can...

Osteomyelitis can be a challenging diagnosis in the pediatric population. Imaging is essential to confirm the presence and location of infection, to distinguish solitary from multifocal disease and to guide interventional procedures. MRI is the most accurate modality to depict bone marrow and soft tissue disease as well as to identify complications and plan surgical treatment.

1. van Schuppen J, van Doorn M, van Rijn R. Childhood osteomyelitis: imaging characteristics. Insights Imaging. 2012; 3: 519–533 2. Ranson M. Imaging of Pediatric Musculoskeletal Infection. Semin Musculoskeletal Radiol 2009; 13: 277–300. 3. Schmit P, Glorion C. Osteomyelitis in infants and children. Eur Radiol. 2004; 14: L44–L54 4. Mellado Santos J. Diagnostic imaging of pediatric hematogenous osteomyelitis: lessons learned from a multi-modality approach. Eur Radiol. 2006; 16: 2109–2119 5. Jaramillo D, Dormans J, Delgado J, Laor T, Geme J. Hematogenous Osteomyelitis in Infants and...