Keywords:
Bones, Computer applications, Musculoskeletal bone, CT, Computer Applications-Detection, diagnosis, Infection, Oedema
Authors:
M. Porta, C. Fanciullo, A. Bonfanti, A. Surace, F. Stanco, A. Aliprandi, S. Sironi
DOI:
10.26044/ecr2023/C-16483
Purpose
Osteomyelitis is defined as a primary bone marrow infection resulting in cortical bone involvement. Osteomyelitis most commonly develops exogenously, from trauma, surgery, or direct spread from adjacent soft tissues. Osteomyelitis can be a diagnostic challenge, further complicated by structural changes in the bone marrow in terms of disuse osteopenia due to prolonged immobilisation, or sclerotic reaction of the bone which makes recognition of bone marrow edema (BME) more difficult. The gold standard for the diagnosis of osteomyelitis is the growth of pathogens from invasively obtained microbiological cultures from bone. However, the diagnosis of osteomyelitis is commonly derived from a combination of clinical, laboratory, microbiological, and imaging evaluations. MRI without contrast has a sensitivity of 88 to 98%, a specificity of 70 to 96% in diagnosing peripheral osteomyelitis. Simple CT has a sensitivity of 69.7% and specificity of 90.2% in detecting osteomyelitis. The aim of our study is to evaluate the utility of dual-energy CT (DECT) in the diagnosis and recognition of BME in patients with infected skin lesions.