Diagnosis of Hematogenous Pyogenic Vertebral Osteomyelitis by Magnetic Resonance Imaging

Magnetic resonance imaging features of fractures using the short tau inversion recovery (STIR) sequence: correlation with radiographic findings

“…Pathologic processes such as osteomyelitis or neoplastic infiltration can prolong T1 and T2 relaxation times and produce tissue signal responses similar to those associated with fracture [1,5,19,24]. The configuration of the abnormal marrow signal has been used to assist in formulating the differential diagnosis [1,3,11,12]. Abnormal signal within an intervertebral disc and adjacent vertebral bodies is a common finding in pyogenic vertebral osteomyelitis [11].…”

“…The configuration of the abnormal marrow signal has been used to assist in formulating the differential diagnosis [1,3,11,12]. Abnormal signal within an intervertebral disc and adjacent vertebral bodies is a common finding in pyogenic vertebral osteomyelitis [11]. Extension of abnormal marrow signal to the cortical margin differentiates fractures from bone contusions, which are limited to the intramedullary compartment [3,12].…”

Intra-individual, randomised comparison of the MRI contrast agents gadobutrol and gadoterate in imaging the distal lower limb of patients with known or suspected osteomyelitis, evaluated in an off-site blinded read

“…Compared with other imaging investigations, MRI has equivalent or greater sensitivity, specificity and accuracy for the detection of bone inflammation. MRI also provides greater spatial resolution in delineating the anatomical extent of infection [2].…”

Pseudomonas aeruginosa costovertebral arthritis in association with spontaneous cervical spondylodiscitis and epidural abscesses in the elderly

“…2,22e25 This is mainly due to its subacute nature, including frequent lack of fever 2,5,10,26 and unspecific clinical symptoms, such as back pain. 2,8,9 Additionally, spondylodiscitis can further be complicated by epidural and paravertebral abscesses, which are believed to be caused by direct contiguous spread of the pathogens from adjacent vertebrae and have been reported in 17% and 26% of the patients with spondylodiscitis, respectively. 21 MRI is the diagnostic imaging of choice for spondylodiscitis.…”

“…6,7 Back pain on the affected vertebrae is the most common presenting symptom and is found in 78%e100% of the patients with spondylodiscitis. 8,9 Conversely, fever has only been reported in 10%e60% of the cases 2,5,10 and only around one-third of the patients have neurologic deficits on presentation. 10 Cervical spondylodiscitis infected by Pseudomonas aeruginosa is rare and only individual cases are reported so far (Table 1).…”