Imaging of Osteomyelitis of the Extremities

Anwer, Usman; Yablon, Corrie M.

doi:10.1053/j.ro.2016.05.011

Cited by 13 publications

(17 citation statements)

References 13 publications

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“…Radiographs. Radiographs are the first study indicated when acute OM has been supposed [6,7]. Destruction of cortical bone, permeative marrow lucency, and periosteal reaction can be observed on x-rays in the case of acute OM [8].…”

Section: Acute Osteomyelitismentioning

confidence: 99%

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Sambri

Spinnato

Tedeschi

et al. 2021

JPM

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Imaging is needed for the diagnosis of bone and joint infections, determining the severity and extent of disease, planning biopsy, and monitoring the response to treatment. Some radiological features are pathognomonic of bone and joint infections for each modality used. However, imaging diagnosis of these infections is challenging because of several overlaps with non-infectious etiologies. Interventional radiology is generally needed to verify the diagnosis and to identify the microorganism involved in the infectious process through imaging-guided biopsy. This narrative review aims to summarize the radiological features of the commonest orthopedic infections, the indications and the limits of different modalities in the diagnostic strategy as well as to outline recent findings that may facilitate diagnosis.

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Section: Acute Osteomyelitismentioning

confidence: 99%

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Sambri

Spinnato

Tedeschi

et al. 2021

JPM

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“…In plain X-rays, suspicious signs for osteomyelitis include cortical erosion, permeative marrow lucency and periosteal reaction or sclerosis, and cortical thickening. CT scans demonstrate subtle cortical erosions earlier than radiographs and reveal sequestra [ 65 ]. MRIs reveal typical findings of osteomyelitis, including edema and enhancement of bone marrow, along with the replacement of bright fatty marrow signal on T1 weighted images with signal closer to the muscle intensity.…”

Section: Discussionmentioning

confidence: 99%

“…T2 marrow hyperintensity and enhancement, as well as T2 hyperintense periosteal edema, may be reactive to adjacent soft tissue infection. Hence, T1 marrow replacement is the most specific sign of marrow infection [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

Osseous Infections Caused by Aspergillus Species

et al. 2022

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Background: Osteomyelitis caused by Aspergillus spp. is a severe, but rare, clinical entity. However, clear guidelines regarding the most effective medical management have not yet been established. The present study is a literature review of all such cases, in an effort to elucidate epidemiology, as well as the therapeutic management and the infection’s outcome. Methods: A thorough review of all reports of osteomyelitis of the appendicular and the axial skeleton, without the skull and the spine, caused by Aspergillus spp. was undertaken. Data about demographics, imaging techniques facilitating diagnosis, causative Aspergillus, method of mold isolation, antifungal treatment (AFT), surgical treatment, as well as the infection’s outcome were recorded and evaluated. Results: A total of 63 cases of osseous infection due to Aspergillus spp. were identified. The studied population’s mean age was 37.9 years. The most commonly affected site was the rib cage (36.8%). Most hosts suffered immunosuppressive conditions (76.2%). Regarding imaging methods indicating diagnosis, computer tomography (CT) was performed in most cases (42.9%), followed by plain X-ray (41.3%) and magnetic resonance imaging (MRI) (34.9%). The most frequent isolated mold was Aspergillus fumigatus (49.2%). Cultures and/or histopathology were used for definite diagnosis in all cases, while galactomannan antigen test was additionally used in seven cases (11.1%), polymerase chain reaction (PCR) in four cases (6.3%), and beta-d-glucan testing in three cases (4.8%). Regarding AFT, the preferred antifungal was voriconazole (61.9%). Most patients underwent surgical debridement (63.5%). The outcome was successful in 77.5%. Discussion: Osteomyelitis due to Aspergillus spp. represents a severe infection. The available data suggest that prolonged AFT in combination with surgical debridement is the preferred management of this infection, while identification of the responsible mold is of paramount importance.

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“…Haematogenous osteomyelitis is more common in children [ 20 ]. In adults, haematogenous osteomyelitis occurs more commonly within the spine, pelvis, and small bones, and is often secondary to bacteraemia from endocarditis, genitourinary infections, gastrointestinal infections, or intravenous drug use [ 75 , 76 ]. Direct inoculation is usually secondary to penetrating trauma or open fracture.…”

Section: Clinical and Magnetic Resonance Imaging Findings Of Musculos...mentioning

confidence: 99%

Magnetic resonance imaging of musculoskeletal infections

Weaver¹,

Omar²,

Mar³

et al. 2022

Pol J Radiol

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Magnetic resonance imaging (MRI) is a powerful imaging modality in the evaluation of musculoskeletal (MSK) soft tissue, joint, and bone infections. It allows prompt diagnosis and assessment of the extent of disease, which permits timely treatment to optimize long-term clinical outcomes. MRI is highly sensitive and specific in detecting the common findings of MSK infections, such as superficial and deep soft tissue oedema, joint, bursal and tendon sheath effusions, lymphadenopathy, bone marrow oedema, erosive bone changes and periostitis, and bone and cartilage destruction and sequestration. Contrast-enhanced MRI allows detection of non-enhancing fluid collections and necrotic tissues, rim-enhancing abscesses, heterogeneously or diffusely enhancing phlegmons, and enhancing active synovitis. Diffusion-weighted imaging (DWI) is useful in detecting soft-tissue abscesses, particularly in patients who cannot receive gadolinium-based intravenous contrast. MRI is less sensitive than computed tomography (CT) in detecting soft-tissue gas. This article describes the pathophysiology of pyogenic MSK infections, including the route of contamination and common causative organisms, typical MR imaging findings of various soft tissue infections including cellulitis, superficial and deep fasciitis and necrotizing fasciitis, pyomyositis, infectious bursitis, infectious tenosynovitis, and infectious lymphadenitis, and of joint and bone infections including septic arthritis and osteomyelitis (acute, subacute, and chronic). The authors also discuss MRI findings and pitfalls related to infected hardware and diabetic foot infections, and briefly review standards of treatment of various pyogenic MSK infections.

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Imaging of Osteomyelitis of the Extremities

Cited by 13 publications

References 13 publications

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Osseous Infections Caused by Aspergillus Species

Magnetic resonance imaging of musculoskeletal infections

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