Osteomyelitis and Septic Arthritis of the Foot and Ankle

Zaki, Islam; Morrison, William B.

doi:10.1016/j.fcl.2023.05.009

Cited by 3 publications

(4 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The absence of osteomyelitis was determined based on the absence of high signal intensity within the bone marrow on fat suppression T2-weighted image or the presence of high signal intensity within the bone marrow on T2-weighted image and absence of abnormal enhancement within the bone marrow (Figure 5). 3,[6][7][8][9][10][11][12] In the present study, there were no cases with high signal intensity within the bone marrow on T2-weighted images and normal enhancement within the bone marrow.…”

Section: Magnetic Resonance Imagingcontrasting

confidence: 47%

“…3,[5][6][7][8] Magnetic resonance imaging (MRI) and radiography play an essential role in the detection and diagnosis of osteomyelitis. 3,[7][8][9][10][11][12] Typical MRI findings for osteomyelitis on MRI are reported to be high signal intensity of bone marrow on fat suppression on T2-weighted images accompanying abnormal gadolinium enhancement. In addition, in cases involving more severe types of osteomyelitis, subperiosteal abscess formation, defined as purulent encapsulated fluid collections within the subperiosteal space, may present as high signal intensity on diffusion-weighted images.…”

mentioning

confidence: 99%

“…4 However, as the symptoms of musculoskeletal soft tissue infection with or without osteomyelitis-such as swelling, pain, and erythema-are nonspecific, imaging evaluation must be performed to differentiate between them. 3,[5][6][7][8] Magnetic resonance imaging (MRI) and radiography play an essential role in the detection and diagnosis of osteomyelitis. 3,[7][8][9][10][11][12] Typical MRI findings for osteomyelitis on MRI are reported to be high signal intensity of bone marrow on fat suppression on T2-weighted images accompanying abnormal gadolinium enhancement.…”

mentioning

confidence: 99%

“…In addition, in cases involving more severe types of osteomyelitis, subperiosteal abscess formation, defined as purulent encapsulated fluid collections within the subperiosteal space, may present as high signal intensity on diffusion-weighted images. 3,[7][8][9][10][11][12] However, MRI incurs high costs, prolongs length of stay, and often requires sedation for pediatric patients. On the contrary, ultrasound can be performed at bedside repeatedly and is not expensive.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Ultrasonography for the Detection of Osteomyelitis in Pediatric Patients With Soft Tissue Infection

Hosokawa,

Deguchi,

Takei

et al. 2024

J of Ultrasound Medicine

View full text Add to dashboard Cite

ObjectivesTo demonstrate the usefulness of ultrasonography for differentiating soft tissue infections with or without osteomyelitis in pediatric patients who underwent ultrasonography and subsequent magnetic resonance imaging (MRI).MethodsTwenty‐three patients were classified into 2 groups: 12 patients with and 11 patients without osteomyelitis based on MRI. Osteomyelitis using ultrasound is characterized by the presence of bone cortex irregularity and/or subperiosteal abscess formation. The diagnostic performance of ultrasonography for detecting osteomyelitis and subperiosteal abscess formation was compared with that of MRI. Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were calculated with 95% confidence intervals (CIs).ResultsOf 12 osteomyelitis cases, 11 had abnormal bone marrow enhancement (one residual case did not undergo contrast enhancement study) and 5 had subperiosteal abscesses. The diagnostic accuracy of ultrasonography for osteomyelitis was 82.6% (number of correct diagnosis of osteomyelitis/total number = 19/23; 95% CI, 61.2–95.0) and for detecting periosteal abscess was 95.7% (number of correct diagnosis of periosteal abscess/total number = 22/23; 95% CI, 78.1–99.9), respectively. The sensitivity and specificity of ultrasonography for detecting osteomyelitis were 66.7% (95% CI, 34.9–90.1) and 100% (95% CI, 71.5–100), respectively. The sensitivity and specificity of ultrasonography for detecting periosteal abscess were 80% (95% CI, 28.4–99.5), and 100% (95% CI, 81.5–100), respectively. One‐third of osteomyelitis cases could not be detected using ultrasonography.ConclusionsUltrasonography may be useful for diagnosing osteomyelitis in pediatric patients; however, the technique appears limited by low sensitivity. However, it is more accurate for diagnosis of periosteal abscess in these patients.

show abstract

Section: Magnetic Resonance Imagingcontrasting

confidence: 47%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Ultrasonography for the Detection of Osteomyelitis in Pediatric Patients With Soft Tissue Infection

Hosokawa,

Deguchi,

Takei

et al. 2024

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

Yield and clinical impact of image-guided bone biopsy in osteomyelitis of the appendicular skeleton: a systematic review and meta-analysis

Smayra,

Miangul,

Witkowiak

et al. 2024

Skeletal Radiol

View full text Add to dashboard Cite

Objective To assess the yield and clinical impact of image-guided bone biopsy for osteomyelitis of the appendicular skeleton. Materials and methods A literature search of several databases was conducted from inception to August 2023. Eligible studies reported patients who underwent image-guided bone biopsy for investigation of osteomyelitis of the appendicular skeleton. The pooled proportions were analyzed using a random-effects model. This review was registered in PROSPERO (CRD42023466419). Results From 370 initial studies screened, eight met the eligibility criteria, with a total of 700 patients. The pooled technical success rate was 99.6% (95% CI: 0.992, 1.001; I2 = 0%). Positive bone cultures were pooled at 31.9% (95% CI: 0.222, 0.416; I2 = 87.83%) and negative cultures at 68.1% (95% CI: 0.584, 0.778; I2 = 87.83%). Methicillin-Sensitive Staphylococcus Aureus and Methicillin-Resistant Staphylococcus Aureus yield was 24.5% (95% CI: 0.096, 0.394; I2 = 90.98%) and 7.6% (95% CI: 0.031, 0.121; I2 = 34.42%) respectively. Group A Streptococcus yield was 7.0% (95% CI: 0.014, 0.127; I2 = 70.94%). Polymicrobial culture yield was 15.7% (95% CI: 0.018, 0.297; I2 = 88.90%). Post-procedural management change rate was 36.5% (95% CI: 0.225, 0.504; I2 = 92.39%). No complications were reported across studies. Conclusion For patients under investigation of osteomyelitis of the appendicular skeleton, image-guided bone biopsy demonstrates a good rate of technical success. Additional studies may provide further support for the use of image-guided bone biopsy in this population. Image-guided bone biopsy results lead to change in antibiotics therapy in a portion of patients with suspected osteomyelitis suggesting its potential utility in select patients.

show abstract