Imaging of chronic posttraumatic osteomyelitis

Kaim, Achim H.; Groß, Thomas; Schulthess, Gustav K. von

doi:10.1007/s00330-001-1141-0

Cited by 78 publications

(71 citation statements)

References 42 publications

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“…Gadolinium-enhanced imaging is helpful in the discrimination of fibrovascular scars from inflammatory active foci. 13,14 Edema pattern on T2-weighted sequences and contrast media enhancement after intravenous gadolinium due to hyperemia and increased endothelial permeability were found as a typical MRI morphology in donors 4 weeks after harvest (group A, Figure 1) and corresponds to the suggested inflammatory and regenerative changes ('acute injury pattern').…”

Section: Discussionmentioning

confidence: 94%

Pelvic magnetic resonance imaging after bone marrow harvest – a retrospective study in 50 unrelated marrow donors

Kroschinsky

Kittner

Mauersberger

et al. 2005

Bone Marrow Transplant

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Summary:A total of 50 unrelated marrow donors were examined by pelvic magnetic resonance imaging (MRI) to investigate the morphological sequelae of bone marrow harvesting (BMH). Signal increase in T2-weighted sequences and contrast media enhancement in T1 sequences at the operative sites were found as typical MRI morphology 4 weeks after harvest (group A, n ¼ 16), corresponding to edema, hyperemia and proliferative activity. Although tissue repair was completed in the majority of donors 1 year after BMH, about 36% of donors in group B (n ¼ 16) had abnormal findings. These included a persistence of the 'acute injury' signal pattern (2/16, 12%), and signal alterations due to fatty marrow conversion (4/16, 24%). The proportion of MRI abnormalities increased to over 70% in two-time donors (group C, n ¼ 11), which might indicate a cumulation of tissue damage after repetitive harvests. If donors had experienced prolonged discomfort after BMH (group D, n ¼ 7), MRI revealed pathological signals in 86%. In conclusion, the MRI morphology reflects the pathophysiological reactions after BMH, including inflammation and tissue repair. A further prospective evaluation in a larger number of donors is necessary to confirm these results and to identify the factors which influence the extent and duration of tissue damage. Bone Marrow Transplantation (2005) 35, 667-673.

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Section: Discussionmentioning

confidence: 94%

Pelvic magnetic resonance imaging after bone marrow harvest – a retrospective study in 50 unrelated marrow donors

Kroschinsky

Kittner

Mauersberger

et al. 2005

Bone Marrow Transplant

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“…It is well known that postoperative reparative tissue and fractures may present with increased FDG uptake [32][33][34]. Increased FDG uptake normalises at around 4 months after traumatic or surgical fractures [15]. The healing process demonstrates most of the cellular components that are present in inflammation [35].…”

Section: Discussionmentioning

confidence: 99%

“…Three of them had prosthetic devices. On the basis of PET findings reported in the literature [14,15], any patients who had experienced trauma or had undergone a surgical intervention on affected bone during the 6 months prior to the PET/CT examination were to be excluded; however, this applied to none of the 33 patients. None of the examined patients was receiving antibiotic treatment at the time of PET/CT scanning.…”

Section: Patientsmentioning

confidence: 99%

Diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis

Hartmann

Eid

Dora

et al. 2006

Eur J Nucl Med Mol Imaging

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103

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Purpose To retrospectively evaluate the diagnostic value of 18 F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis. Methods Thirty-three partial body 18 F-FDG PET/CT scans were performed in 33 patients with trauma suspected of having chronic osteomyelitis. In 10 and 23 patients, infection was suspected in the axial and appendicular skeleton, respectively. In 18 patients, PET/CT was performed in the presence of metallic implants. Histopathology or bacteriological culture was used as the standard of reference. For statistical analysis, sensitivity, specificity and accuracy were calculated in relation to findings of the reference standard. Results Of 33 PET/CT scans, 17 were true positive, 13 true negative, two false positive and one false negative. Eighteen patients had chronic osteomyelitis and 15 had no osseous infection according to the reference standard. Sensitivity, specificity and accuracy for 18 F-FDG PET/CT was 94%, 87% and 91% for the whole group, 88%, 100% and 90% for the axial skeleton and 100%, 85% and 91% for the appendicular skeleton, respectively. Conclusion18 F-FDG PET/CT is a highly sensitive and specific method for the evaluation of chronic infection in the axial and appendicular skeleton in patients with trauma. PET/CT allows precise anatomical localisation and characterisation of the infectious focus and demonstrates the extent of chronic osteomyelitis with a high degree of accuracy.

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“…However in contrast to bone scintigraphy, FDG PET rapidly normalizes after traumatic or surgical fractures (14,16) as fibroblast predominate in normally healing bone, and FDG uptake quickly subsides 4 months after surgery (17). The healing process shows most of the cells that are present in inflammation (18).…”

Section: Osteomyelitismentioning

confidence: 99%

Osteomyelitis and Arthritis

Stumpe

Strobel

2009

Seminars in Nuclear Medicine

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Infections of bone and the joints can represent major diagnostic and therapeutic challenges to all clinicians. Together with osteomyelitis and septic arthritis, soft-tissue infections like cellulites/fasciitis and abscess formation can occur, which have to be treated appropriately. Bone scintigraphy is a sensitive method that can be used to search for bone and joint infections. Labeled leukocytes often are used as the gold standard to identify infectious foci in the musculoskeletal system, but major drawbacks of this method are the imaging of chronic infections and imaging of the axial skeleton. Like (111)In-labeled leukocyte imaging, (99m)Tc-labeled antigranulocyte antibody scintigraphy has a role in the imaging of osteomyelitis of the peripheral skeleton. Magnetic resonance imaging is widely used to evaluate musculoskeletal infections and is excellent in identifying abscess formation, but the extent and spread of infection is sometimes difficult to delineate because hyperemia and infection are not congruent.

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Imaging of chronic posttraumatic osteomyelitis

Cited by 78 publications

References 42 publications

Pelvic magnetic resonance imaging after bone marrow harvest – a retrospective study in 50 unrelated marrow donors

Pelvic magnetic resonance imaging after bone marrow harvest – a retrospective study in 50 unrelated marrow donors

Diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis

Osteomyelitis and Arthritis

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