The Radiology of Osteomyelitis

Bonakdarpour, Akbar; Gaines, Victor D.

doi:10.1016/s0030-5898(20)30211-x

Cited by 115 publications

(8 citation statements)

References 31 publications

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“…Of the remaining 27 patients, we were able to contact 12. Reasons for failed follow-up contact included the following: unlisted or incorrect phone number (11), not able to be reached despite at least 2 attempts (2), and moved before the completion of therapy (2). Time after diagnosis of S/CO ranged from 8 months to 7 years.…”

Section: Follow-upmentioning

confidence: 99%

“…Sequestrae and involucrae typically take at least 3 weeks to appear. 2 Exudate may also extend into the surrounding soft tissue through cloacae, which are holes in the involucrum. When sequestrae or involucrae become fibrotic, sclerosis may result; bone sclerosis usually indicates disease that has been present for more than 1 month.…”

Section: Introductionmentioning

confidence: 99%

“…3 S/CO is characterized radiographically by involucrae, sequestrae, fibrosis, irregular cortical margins, and sclerosis. 2 On the basis of etiology, Waldvogel et al 3 divided osteomyelitis into 3 types: hematogenous, contiguous focus, or associated with systemic disease. Recognition of the pathophysiology of osteomyelitis allows for identification of associated conditions or risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Auh

Binns

Katz

2004

Clin Pediatr (Phila)

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To identify factors associated with and to describe treatment outcomes of pediatric subacute or chronic osteomyelitis (S/CO), we retrospectively identified 52 patients with S/CO from January 1994 to November 1999 seen at a large pediatric hospital infectious disease clinic. S/CO was defined by the following: >10 days of clinical symptoms; radiographic, surgical, or pathologic changes consistent with S/CO; or relapse of prior osteomyelitis. Of these patients 63% were male, median age 9 years. Bones involved included vertebra (19% of subjects), femur (17%), finger (12%), humerus (10%), and tibia (8%). Sixty-five percent had at least 1 risk factor (most commonly hardware, neurologic disease or preceding trauma, sepsis, or surgery). Blood, bone, or wound aspirate cultures were positive in 67%, most commonly for Staphylococcus aureus. Erythrocyte sedimentation rate (ESR) was elevated in 88% of 41 patients at the time of diagnosis. Intravenous antibiotics were given for a median of 6 weeks and oral antibiotics for a median of 4.5 months. One child had a complication. In conclusion, consideration of S/CO should be high when predisposing factors are present. ESR may be useful for determining effectiveness and duration of therapy. With prolonged antibiotic therapy nearly all patients demonstrated resolution of disease.

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Section: Follow-upmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Auh

Binns

Katz

2004

Clin Pediatr (Phila)

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“…A cloaca may present as focal partial-thickness defect (incomplete) or full-thickness perforation within the involucrum of varying sizes. On radiographs, the visibility of a cloaca depends on the location relative to the direction of the X-ray beam [ 117 ], whereas even small and incomplete cloaca are well visible on high-resolution CT images [ 118 ]. MRI can demonstrate and characterize a cloaca to better advantage, although the mineralized contents are less well visualized than on CT image.…”

Section: Necrosismentioning

confidence: 99%

MRI nomenclature for musculoskeletal infection

et al. 2021

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The Society of Skeletal Radiology (SSR) Practice Guidelines and Technical Standards Committee identified musculoskeletal infection as a White Paper topic, and selected a Committee, tasked with developing a consensus on nomenclature for MRI of musculoskeletal infection outside the spine. The objective of the White Paper was to critically assess the literature and propose standardized terminology for imaging findings of infection on MRI, in order to improve both communication with clinical colleagues and patient care.A definition was proposed for each term; debate followed, and the committee reached consensus. Potential controversies were raised, with formulated recommendations. The committee arrived at consensus definitions for cellulitis, soft tissue abscess, and necrotizing infection, while discouraging the nonspecific term phlegmon. For bone infection, the term osteitis is not useful; the panel recommends using terms that describe the likelihood of osteomyelitis in cases where definitive signal changes are lacking. The work was presented virtually to SSR members, who had the opportunity for review and modification prior to submission for publication.

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“…These osseous changes only become evident after osteomyelitis has been present for 10-14 days and require up to 50% bone loss before becoming apparent on x-ray. 57 The sensitivity of the Xray ranges 52-93% and specificity 33-92% for the detection of osteomyelitis. On the other hand Computed Tomography (CT) scan is superior to X-ray in detection of cortical destruction, periostitis and soft tissue or intraosseous gas.…”

Section: Table 2 Classification and Severity Of Diabetic Foot Infectionmentioning

confidence: 99%

Factors that influence the healing process in lower limb ulcers of diabetic patients

Lareyre¹,

Σπανός²

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Σύμφωνα με το Παγκόσμιο Οργανισμό Υγείας (Π.Ο.Υ.), μπορεί κάποιος να περικλείσει όλες τις επιπλοκές του κάτω άκρου των ασθενών με σακχαρώδη διαβήτη (ΣΔ), στον ορισμό διαβητικό πόδι (διαβητικό έλκος), που περιλαμβάνει το ‘έλκος του κάτω άκρου το οποίο σχετίζεται με νευροπάθεια και διαφορετικούς βαθμούς ισχαιμίας και φλεγμονής’. Στις ημέρες μας, το διαβητικό πόδι αποτελεί ένα προφανές παγκόσμιο πρόβλημα με μεγάλη επιρροή στο κόστος συσχετιζόμενο με την υγεία, την ποιότητα ζωής των ασθενών και του κοινωνικού τους περιβάλλοντος, και εν τέλει στην αυξημένη θνησιμότητα και νοσηρότητα αυτών των ασθενών. Σε αυτό το πλαίσιο, διενεργήσαμε αυτή την προοπτική, μη τυχαιοποιημένη μελέτη παρατήρησης, σε διαδοχικούς διαβητικούς ασθενείς με έλκος κάτω άκρου, για να αξιολογήσουμε του παράγοντες που σχετίζονται με τη διαδικασία επούλωσης του έλκους ή διάσωσης του κάτω άκρου, και να εκτιμήσουμε την επίδραση της θεραπείας τους στο επίπεδο ζωής τους. Επιπροσθέτως, διενεργήσαμε έρευνα υπό την αιγίδα της Μεσογειακής Αγγειολογικής και Αγγειοχειρουργικής εταιρείας (Mediterranean League of Angiology and Vascular Surgery, MLAVS) με σκοπό να επισημάνουμε τις σύγχρονες τάσεις αντιμετώπισης του διαβητικού ποδιού ανάμεσα σε Αγγειολόγους και Αγγειοχειρουργούς της περιοχής της Μεσογείου.Κατά τη διάρκεια της κλινικής εκτίμησης, αντιμετώπισης και παρακολούθησης των διαβητικών ασθενών, αξιολογήσαμε την εγκυρότητα της εφαρμογής του κλινικού ερωτηματολογίου εκτίμησης των συμπτωμάτων και σημείων της νευροπάθειας του Λιντς (Leeds Assessment of Neuropathic Symptoms and Signs, LANSS) σε ελληνικό πληθυσμό ασθενών. Εν κατακλείδι, το διαβητικό πόδι αποτελεί ένα συνεχώς αυξανόμενο παγκόσμιο κοινωνικο-οικονομικό πρόβλημα με υψηλή θνησιμότητα και νοσηρότητα για τους ασθενείς αυτούς. Η ιατρική κοινότητα πρέπει να λάβει σοβαρά υπόψη της αυτό το τεράστιο κλινικό θέμα και να μην το θεωρήσει αντικείμενο μιας ειδικότητας ιατρών αλλά ότι χρήζει της προσοχής και αντιμετώπισης μιας οργανωμένη πολυπρόσωπης ομάδας.

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The Radiology of Osteomyelitis

Cited by 115 publications

References 31 publications

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

MRI nomenclature for musculoskeletal infection

Factors that influence the healing process in lower limb ulcers of diabetic patients

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