Learning objectives
Tobriefly review the pathophysiology and clinical features ofosteomyelitis.
To review theimaging findings of osteomyelitis with different imaging modalities.
To summarily describe age-related differences in the patterns of disease.
Background
Osteomyelitis (OM) is defined as an infection of the bone marrow and adjacent osseous structures with potential surrounding soft tissue extent,
with possible progression to osteonecrosis,
bone destruction,
and septic arthritis.
It is an important cause of permanent disability in both children and adults worldwide.
The age distribution is bimodal,
with peak incidences in children under 5 and adults over 50 years of age.
Clinical manifestations differ according to the age of the patients.
In infants,
findings are often more pronounced and include local swelling,...
Imaging findings OR Procedure Details
Pathogenesis
Generally one may distinguish three clinical stages (acute,
subacute and chronic),
although there may be some overlap.
Acute osteomyelitis is typical of children,
has a rapid onset and may present with systemic toxicity.
The bones most commonly affected are the tibia,
the femur,
and the humerus.
Although it is relatively uncommon in healthy adults,
it can occur in immunocompromised individuals or intravenous drug abusers.
The subacute stage or Bodie’s abscess is more insidious and can be due to inadequate treatment or low virulence of...
Conclusion
Imaging plays a central role in the diagnosis and management of osteomyelitis.
Plain radiographs should be obtained first to exclude other pathologies such as fractures and asa means of assessing progress after treatment.MRI is the best imaging modality for establishing the diagnosis of osteomyelitis as it can demonstrate bone marrow edema,
depict the presence of abscesses and delineate the extraosseous disease.
Ultrasound is the preferred modality in case of suspicion of acute osteomyelitis in children or concomitant septic arthritis.
CT may be useful in the...
References
1.
Desimpel J,
Posadzy M,
Vanhoenacker F.
The Many Faces of Osteomyelitis: A Pictorial Review.
Journal of the Belgian Society of Radiology.
2017; 101(1): 24,
pp.
1–10.
2.
Pineda C,
Vargas A,
Rodríguez AV.
Imaging of Osteomyelitis: Current Concepts.
Infect Dis Clin N Am.
2006; 20:789–825.
3.
Khan SHM,
Bloem HL.
“Infection in the Appendicular Skeleton (Including Chronic Osteomyelitis)”,
in Pope T et al (ed.),Musculoskeletal Imaging.
Saunders,
pp.
1255-1268.
4.
Lee YJ,
Sadigh S,
Mankad K,
Kapse N,
Rajeswaran G.
The imaging of osteomyelitis.
Quant...