Magnetic Resonance Imaging of Appendicular Musculoskeletal Infection

Lalam, Radhesh; Cassar‐Pullicino, Victor N.; Tins, Bernhard

doi:10.1097/rmr.0b0318123eee56

Cited by 30 publications

(16 citation statements)

References 37 publications

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“…Of the currently available imaging modalities to aid in the diagnosis of pediatric osteomyelitis, MRI remains the most accurate, with a sensitivity and specificity dramatically higher than radiographs or bone scintigraphy [30]. Unlike conventional radiographs, MRI can detect subtle changes at the onset of infection [31] and unlike bone scintigraphy, is non-radioactive and provides an ability to visualize intraosseous abscesses, joint effusions, and myositis [32][33][34]. MRI changes most consistent with osteomyelitis include bone marrow hyperintensity on T2-weighted images, a finding that is best seen with gadolinium contrast, and surrounding inflammation of the soft tissue [33].…”

Section: Imaging Modalitiesmentioning

confidence: 98%

Advances in the Diagnosis and Management of Pediatric Osteomyelitis

Thomsen

Creech

2011

Curr Infect Dis Rep

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Acute hematogenous osteomyelitis is a common disease that affects previously healthy children of all age groups. Despite its importance, there are limited data in the current literature to guide many aspects of the diagnosis and therapy of this infection. Over the last decade, our understanding of the etiology of this infection has changed, with increased recognition of Kingella kingae and the dramatic increase in community-associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infections. There is a need for the optimization of diagnostic strategies, such as MRI and serum inflammatory markers. Several recent studies have examined treatment strategies, including a rapid transition to oral antimicrobial therapy and a shortened overall course of therapy. Many new therapeutic options are on the horizon that will likely impact the management of this and other childhood bacterial infections. This review summarizes recent investigations into the optimal diagnosis and management of acute hematogenous osteomyelitis in children.

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Section: Imaging Modalitiesmentioning

confidence: 98%

Advances in the Diagnosis and Management of Pediatric Osteomyelitis

Thomsen

Creech

2011

Curr Infect Dis Rep

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“…The rim surrounding the abscess is hypo-intense on T2-weighted images and enhances after intravenous administration of gadolinium-based contrast material, whereas necrotic tissue and purulent material show no enhancement. 28,29 Abscesses are of variable size and extent, and typically form deep within the infected muscle. On rare occa- sions, an abscess may be mistaken for myonecrosis because both abnormalities are characterized by contrast enhancement at the periphery of lesion; generally speaking, abscess may be differentiated on T2-weighted images by the presence of central high signal intensity and a mass effect.…”

Section: Discussionmentioning

confidence: 99%

Adult bacterial myositis: report of a single-center series of 26 cases

Gallucci

Ronga

Pietto³

et al. 2016

Ital J Med

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Bacterial infections involving muscle are quite uncommon and generally require specific predisposing factors. Bacterial myositis is more rarely described in the typical kind of patients observed in Internal Medicine (presence of multiple co-morbidities, partial/limited immune-deficiency, advanced age). Twenty-six patients suffering from bacterial myositis (8 women and 18 men; mean age 58.5 years, range 27-82) observed in a single Internal Medicine Unit were reported. Muscles involved were ileopsoas, thigh, paravertebral, gluteus, calf, forearm and rectus abdomen. Simultaneous presence of arthritis was registered in 17 patients and all patients presented relevant comorbidity. Main cultured bacteria were <em>Staphylococcus aureus, Escherichia coli</em>, other Gram-negative bacteria, <em>Streptococcus spp.</em> Multi-drug-resistance was observed in 14 out 26 (53.8%). Computed tomography, ultrasound and magnetic resonance imaging were utilized for diagnostic purposes. Antibiotic treatment was administered to all patients. Surgical debridement and drainage were performed in 12 patients; 7 patients were treated with percutaneous aspiration and drainage. At discharge, relevant functional impairment was present in 17 patients (65.3%). Four patients died (in-hospital mortality 7.6%, global mortality at three months 15.3%). Management of bacterial myositis is difficult and its prognosis is poor. In the near future, this demanding infection will be more frequently observed in Internal Medicine setting as comorbidity, which is very often the main characteristic of these patients.

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“…Die MR-Morphologie von Weichteilabszessen nach Tumorresektion entspricht generell der von Abszessen anderer Ursache, mit einer umschriebenen Flüssigkeitsretention, auf T1w hypooder intermediär intens, hyperintens auf T2w ohne zentrales Enhancement, mit hypointensem, dickem irregulärem, enhancendem Randsaum [47,84]. Allerdings ist die Differenzialdiagnose gegenüber Seromen aufgrund der ohnehin bestehenden posttherapeutischen diffusen Veränderungen erschwert.…”

Section: Infektion/abszessunclassified

Weichteilsarkome: Wie lassen sich posttherapeutische Veränderungen von Rezidiven unterscheiden?

Noebauer-Huhmann

Grieser

2017

Radiologe

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Die Diagnostik und Therapie von Patienten mit Weichteiltumoren konnte in den letzten Jahrzehnten verbessert werden, auch durch interdisziplinär in Tumorboards abgesprochenes optimiertes und standardisiertes Vorgehen [10,18,25,36,92]. Dadurch konnten bei Extremitätensarkomen sehr niedrige Lokalrezidivraten von nur 4,1 % nach 5 Jahren erreicht werden, in einer anderen Studie mit extremitätenerhaltender Resektion und postoperativer Radiatio Raten von 9 % nach 5 bzw. 12 % nach 10 Jahren [25,60] [23,56,60,99].

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Magnetic Resonance Imaging of Appendicular Musculoskeletal Infection

Cited by 30 publications

References 37 publications

Advances in the Diagnosis and Management of Pediatric Osteomyelitis

Advances in the Diagnosis and Management of Pediatric Osteomyelitis

Adult bacterial myositis: report of a single-center series of 26 cases

Weichteilsarkome: Wie lassen sich posttherapeutische Veränderungen von Rezidiven unterscheiden?

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