Keywords:
Musculoskeletal bone, Musculoskeletal joint, Musculoskeletal soft tissue, MR, CT, Conventional radiography, Education, Infection, Abscess, Inflammation
Authors:
C. D. O. Mira1, G. Freire1, M. Ataíde2, P. D. Afonso3; 1Loures/PT, 2Lisboa/PT, 3Lisbon/PT
DOI:
10.26044/essr2019/P-0059
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,
pain,
reduced movement or refusal to move the affected limb,
particularly in the acute phase.
On the contrary,
in adults,
the onset is often more insidious.
There are also differences in the location of the infection according to age group.
While in children the tubular bones such as tibia and femur are the most common sites of infection,
the axial skeleton is most frequently affected in adults.
Typical laboratory findings include an increase of c-reactive protein (CRP) and erythrocyte sedimentation sate (ESR),
especially in acute osteomyelitis in children.
Although cultures are fundamental for accurate treatment,
they are only positive in half of the situations.
Osteomyelitis is a heterogeneous disease in pathophysiology,
clinical presentation,
and management.
Although clinical diagnosis in the late stages can be achieved easily,
an accurate early diagnosis is more challenging and is fundamental to increase the cure rate and to avoid morbidity. Therefore imaging can be an important aid,
often requiring the combination of different modalities.