Imaging-Guided Bone Biopsy for Osteomyelitis: Are There Factors Associated with Positive or Negative Cultures?

Abstract

The rate of positive culture results in histologically proven cases of osteomyelitis obtained from imaging-guided bone biopsies is low. Aspirating > or = 2 mL of purulent fluid is associated with a significantly higher rate of positive cultures.

Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review

“…However, a definitive diagnosis of the causative micro-organism is very difficult to establish based on clinical features and imaging alone. Therefore, image-guided percutaneous spinal biopsies are being increasingly performed to get sufficient tissue for culture and sensitivity of the causative organism [24]. However, the biopsy diagnostic yield of percutaneous spinal biopsy for detecting infection ranges from 30 to 40% and aspiration of > or = 2 mL of purulent fluid reported increases the rate of positive cultures [24].…”

Membrane Induced Osteogenesis in the Management of Posttraumatic Bone Defects

“…29 Treatment with antibiotics before admission might decrease the bacterial recovery, and a histopathologic analysis can be useful to improve the diagnosis and distinguish established infection from wound contamination. 30 In our series, tissue cultures were performed every time the wound was addressed, and this may have favored bacterial identification. Although clinical signs of infection were not present, some cases had positive cultures in the second stage, so systemic antibiotics were administered.…”

New Antibiotics in the Therapy of Osteomyelitis

“…Antibiotic prophylaxis given at the induction of anesthesia does not interfere with intraoperative sampling cultures [1] . If image-guided needle biopsy is obtained, at least 2 mL of fluid should be aspirated to improve sensitivity [24] . Depending on endemic and patient-specific factors, rarer pathogens like mycobacteria and fungi should be searched for.…”