Osteomyelitis: characteristics and pitfalls of diagnosis with MR imaging.

Erdman, William A.; Tamburro, Fabio; Jayson, Hal T.; Weatherall, Paul T.; Ferry, Kathryn; Peshock, Ronald M

doi:10.1148/radiology.180.2.2068324

Cited by 242 publications

(107 citation statements)

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“…The combination of these images increases specificity from 75 to 82%. 19 The sensitivity is 100%. The CT is particularly useful in the evaluation of intramedullary osteitis.…”

Section: Mri and Ctmentioning

confidence: 99%

Management of infected nonunion of long bones: The last decade (1996–2006)

Motsitsi

2008

Injury

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SummaryInfected nonunion is one of the most challenging orthopaedic complications to manage. There is considerable morbidity associated with infected nonunion. There is significant impact on the life of the patient; social, financial, physical, and mental. Infected nonunion may be a limb-threatening complication.Significant progress has been made in the management of infected nonunion in the last decade. There are clear guidelines for pre-operative evaluation and treatment strategy. The recommended strategy is the 'infection-elimination first' strategy. This strategy involves two steps: control of infection by local radical debridement of dead tissue followed by reconstruction. There are four operative techniques (with considerable overlap among them) which have been used in the past decade: Ilizarov, intramedullary devices with or without the use of external fixator, free tissue transfer, and in situ reconstruction.Bone results are, in general, better compared to functional results. Overall, the outcome following treatment of infected nonunion are good to excellent.

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“…The combination of these images increases specificity from 75 to 82%. 19 The sensitivity is 100%. The CT is particularly useful in the evaluation of intramedullary osteitis.…”

Section: Mri and Ctmentioning

confidence: 99%

Management of infected nonunion of long bones: The last decade (1996–2006)

Motsitsi

2008

Injury

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“…The MRI findings in SBO are classical. Highly sensitive but non-specific MR findings of osteomyelitis include marrow T1 hypointensity and T2 hyperintensity [9]. Chang et al reported clival marrow and preclival soft tissue abnormalities in all their cases [1].…”

Section: Discussionmentioning

confidence: 99%

Central Skull Base Osteomyelitis: Diagnostic Dilemmas and Management Issues

Muranjan

Khadilkar

Wagle

et al. 2015

Indian J Otolaryngol Head Neck Surg

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The aim of this study is to describe the clinical presentation of central skull base osteomyelitis and to discuss the classical imaging findings and various diagnostic and therapeutic challenges faced in the management of this condition. This is a retrospective analysis of inpatient case records, carried out in a multidisciplinary tertiary care hospital. The study subjects included five elderly diabetic patients presenting to the ENT surgeon or neurologist with headache followed by multiple cranial nerve paralysis with no temporal bone involvement in four patients and a past history of otitis externa in one patient. These patients were diagnosed to have an infective pathology of the central skull base detected by imaging and confirmed by biopsy in three. All were treated successfully with antibiotics administered for an average period of 6 weeks. Three patients followed up over 4 years and showed no relapses. One succumbed to other medical co morbidities after 8 months and one diagnosed a month prior is still under follow up. A symptom complex of headache and cranial neuropathies usually raises the suspicion of malignancy. Central skull base osteomyelitis, a relatively uncommon pathology, must also be considered as a possible differential diagnosis despite absence of a definite septic focus. Imaging studies showing bony destruction and adjacent soft tissue involvement should raise the suspicion of this clinical entity. Malignancy needs to be ruled out by biopsy. Early diagnosis and prompt initiation of antibiotics administered for an adequate duration is of paramount importance in successfully treating these patients. A multidisciplinary approach is needed for a successful outcome.

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“…MRI has high sensitivity and specificity for the diagnosis of both osteomyelitis and soft tissue infections [7,11]. MRI accurately depicts edematous, diseased bone and differentiates diseased bone from normal bone.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) has high sensitivity for the diagnosis of musculoskeletal infection and also delineates with detail the extent of the osseous and soft tissue involvement [7,11,15,17]. Studies on pediatric pelvic osteomyelitis using MRI demonstrate adjacent muscle abscesses in 20% to 55% of patients [4,5,14,15,17].…”

Section: Introductionmentioning

confidence: 99%