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

Sambri, Andrea; Spinnato, Paolo; Tedeschi, Sara; Zamparini, Eleonora; Fiore, Michele; Zucchini, Riccardo; Giannini, Claudio; Caldari, Emilia; Crombé, Amandine; Viale, Pierluigi

doi:10.3390/jpm11121317

Cited by 22 publications

(38 citation statements)

References 151 publications

(175 reference statements)

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“…Gadolinium-enhanced sequences help to outline zones of necrosis ( 71 ), and are useful for detecting abscesses, whether subperiosteal or intraosseous ( 67 ). However, recent reports, demonstrating pathological retention in brain tissue of children exposed to gadolinium-based contrast agents (GBCAs) should encourage radiologists to avoid its unnecessary use in pediatric patients ( 72 – 74 ). MRI can also help to plan treatment, particularly the percutaneous drainage of fluid collections and surgical debridement; it enables an assessment of the extent of necrotic tissue and the definition of dangerous contiguous structures that will need customized management to avoid morbidity and complications ( 75 ).…”

Section: Radiological Investigation: the Key To Tailored Surgical Tre...mentioning

confidence: 99%

Surgery's role in contemporary osteoarticular infection management

Marco¹,

Vázquez²,

Gavira³

et al. 2022

Front. Pediatr.

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The treatment paradigm for osteoarticular infections (OAIs) has changed drastically over the past 80 years, from the advent of penicillin to the use of broad-spectrum antibiotics. Before these drugs, surgery was the only available treatment for OAIs; today, antibiotic therapy is considered the primary response to them. As a result, surgical treatment of OAIs is thus far more rarely indicated, sometimes even considered outdated and obsolete. However, long experience has taught us that many OAI contexts can still benefit from surgical management, constituting an essential complement to medical treatment. The present article seeks to contextualize this discussion by providing a chronological review of the surgical treatments used in cases of OAI and describing the quality of evidence supporting their rehabilitation in well-established situations.

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Section: Radiological Investigation: the Key To Tailored Surgical Tre...mentioning

confidence: 99%

Surgery's role in contemporary osteoarticular infection management

Marco¹,

Vázquez²,

Gavira³

et al. 2022

Front. Pediatr.

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show abstract

“…Regarding nuclear medicine, the initial radionuclide test made is generally bone scintigraphy; this has high sensitivity, but low specificity, but if it is negative the diagnosis of PJI can be excepted. In the case of positive bone scintigraphy, the addition of labeled leukocyte scintigraphy significantly increases the diagnostic reliability for PJIs [ 23 ]. Therefore, in the case of a confirmed PJI, all other replaced joints should be investigated.…”

Section: Resultsmentioning

confidence: 99%

Synchronous Periprosthetic Joint Infections: A Scoping Review of the Literature

et al. 2022

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Prosthetic joint infections (PJIs) occurring in multiple joints at the same time (synchronous PJI) are an extremely rare complication, frequently associated with bacteremia, and are associated with high mortality rates. The presence of three or more prosthetic joints, rheumatoid arthritis, neoplasia, bacteremia and immune-modulating therapy seem to be the recurring risk factors for synchronous PJI. In case of PJIs, all other replaced joints should be considered as potentially infected and investigated if PJI is suspected. Treatments of synchronous multiple PJIs vary and must be decided on a case-by-case basis. However, the advantages of one-stage exchange seem to outweigh the two-stage protocol, as it decreases the number of necessary surgical procedures. Nonetheless, too few studies have been conducted to allow firm conclusions about the best handling of synchronous PJI. Thus, additional studies are needed to understand this devastating complication and to design the most appropriate diagnostic and therapeutic path.

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“…Pseudotumor lesions share imaging characteristics with neoplastic lesions such as periosteal reactions, bone destruction patterns, contrast enhancement patterns on MRI etc. Meticulous attention should be paid to history of contact with animals or animal products and immune status of the patients [34].…”

Section: Discussionmentioning

confidence: 99%

Tumor-mimicking musculoskeletal infectious lesions: Experience of a single referral center

et al. 2022

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Introduction/Objectives. Bone and soft tissue infections might mimic bone and soft tissue tumors. Therefore, differential diagnosis is important to prevent errors in treatment. This report aims to present the data of patients with indistinct clinical and radiological findings mimicking benign and malignant bone and soft tissue tumors, which were later diagnosed as inflammatory infections. Methods. A retrospective chart review of the clinical, microbiological, radiologic, and pathologic findings of patients presented with a presumed diagnosis of a possible malignant lesion was performed. Results. The study included 21 patients with a median age (IQR) of 37 (1 month ? 72 years) years, and 13 (61%) patients were men. In total, 16 (76%) patients were admitted to the hospital with complaints of pain. The diagnoses were hydatid cyst, tuberculous osteomyelitis, cat-scratch disease, chronic osteomyelitis, subacute osteomyelitis, and soft tissue abscess. All patients were treated depending on the diagnosis of the lesion. Conclusion. There are chances of misdiagnosis due to shared common characteristics of tumoral and infectious lesions which might be mildly increased inflammatory markers with deeply seated non-mobile soft tissue masses and aggressive periosteal reactions and/or bone destruction patterns. So, each pseudotumoral lesion due to possible infectious causes should be histopathologically examined and correlated with other clinical and laboratory data in order to achieve a final diagnosis

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

Cited by 22 publications

References 151 publications

Surgery's role in contemporary osteoarticular infection management

Surgery's role in contemporary osteoarticular infection management

Synchronous Periprosthetic Joint Infections: A Scoping Review of the Literature

Tumor-mimicking musculoskeletal infectious lesions: Experience of a single referral center

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