Radiologie up2date 2003; 3(2): 133-153
DOI: 10.1055/s-2003-39874
Muskuloskelettale Erkrankungen
© Georg Thieme Verlag Stuttgart · New York

Radiologische und nuklearmedizinische Diagnostik der Osteomyelitis

Radiological and Nuclear-Medical Diagnostics of OsteomyelitisHans  Peter  Ledermann1 , Achim  H.  Kaim2
  • 1 Radiologisches Institut Universitätsspital Basel
  • 2 Institut für Radiologie, Klinik im Schachen, Aarau
Further Information

Publication History

Publication Date:
17 June 2003 (online)


In dieser Übersichtsarbeit werden in einem ersten Teil die verschiedenen radiologischen Untersuchungsmethoden bezüglich ihrer Wertigkeit bei der Abklärung einer Osteomyelitis diskutiert. In einem zweiten Teil wird dann die Abklärung der häufigsten Formen der Osteomyelitis systematisch beschrieben.


The first part of this review provides a discussion of the commonly used radiological methods in the workup of bone infections (techniques). In a second part the radiological findings of the most frequent forms of osteomyelitis are described systematically.


  • 1 Bielecki D K, Sartoris D, Resnick D. et al . Intraosseous and intradiscal gas in association with spinal infection: report of three cases.  AJR. 1986;  147 83-86
  • 2 Bonakdar-pour A, Gaines V D. The radiology of osteomyelitis.  Orthop Clin North Am. 1983;  14 21-37
  • 3 Dagirmanjian A, Schils J, McHenry M C. MR imaging of spinal infections.  Magn Reson Imaging Clin N Am. 1999;  7 525- 538
  • 4 Dalinka M K, Lally J F, Koniver G, Coren G S. The radiology of osseous and articular infection.  CRC Crit Rev Clin Radiol Nucl Med. 1975;  7 1-64
  • 5 Gillams A R, Chaddha B, Carter A P. MR appearances of the temporal evolution and resolution of infectious spondylitis.  AJR. 1996;  166 903-907
  • 6 Kaim A, Ledermann H P, Bongartz G. et al . Chronic post-traumatic osteomyelitis of the lower extremity: comparison of magnetic resonance imaging and combined bone scintigraphy/immunoscintigraphy with radiolabelled monoclonal antigranulocyte antibodies.  Skeletal Radiol.. 2000;  29 378-386
  • 7 Kaim A, Maurer T, Ochsner P. et al . Chronic complicated osteomyelitis of the appendicular skeleton: diagnosis with technetium-99 m labelled monoclonal antigranulocyte antibody-immunoscintigraphy.  Eur J Nucl Med. 1997;  24 732-738
  • 8 Kaim A, Ochsner P, Maurer T, Jundt G, Mueller-Brand J. Ectopic hematopoietic bone marrow in the appendicular skeleton after trauma.  J Nucl Med. 1998;  39 1980-1983
  • 9 Kaim A H, Gross T, Schulthess G K von. Imaging of chronic posttraumatic osteomyelitis.  Eur Radiol. 2002;  12 1193-1202
  • 10 Kaim A H, Jundt G, Wischer T. et al .Functional-morphologic MR imaging in acute and chronic soft tissue infection by means of ultra small particles of iron oxide (USIPO) - a study in rats. Radiology 2003: (in Press)
  • 11 Kaim A H, Weber B, Kurrer M O. et al . Autoradiographic quantification of 18F-FDG uptake in experimental soft-tissue abscesses in rats.  Radiology. 2002;  223 446-451
  • 12 Ledermann H P, Kaim A, Bongartz G, Steinbrich W. Pitfalls and limitations of magnetic resonance imaging in chronic posttraumatic osteomyelitis.  Eur Radiol. 2000;  10 1815-1823
  • 13 Ledermann H P, Morrison W B, Schweitzer M E, Raikin S M. Tendon Involvement in Pedal Infection: MR Analysis of Frequency, Distribution, and Spread of Infection.  AJR. 2002;  179 939-947
  • 14 Ledermann H P, Morrison W B, Schweitzer M E. MR image analysis of pedal osteomyelitis: distribution, patterns of spread, and frequency of associated ulceration and septic arthritis.  Radiology. 2002;  223 747-755
  • 15 Ledermann H P, Morrison W B, Schweitzer M E. Pedal Abscesses in Patients Suspected of Having Pedal Osteomyelitis: Analysis with MR Imaging.  Radiology. 2002;  224 649-655
  • 16 Ledermann H P, Schweitzer M E, Morrison W B, Carrino J A. MR Imaging Findings in Spinal Infections: Rules or Myths?. Radiology 2003: (in Press)
  • 17 Ledermann H P, Schweitzer M E, Morrison W B. Nonenhancing tissue on MR imaging of pedal infection: characterization of necrotic tissue and associated limitations for diagnosis of osteomyelitis and abscess.  AJR. 2002;  178 215-222
  • 18 Miller T T, Randolph-DAJ , Staron R B, Feldman F, Cushin S. Fat-suppressed MRI of musculoskeletal infection: fast T2-weighted techniques versus gadolinium-enhanced T1-weighted images.  Skeletal Radiol. 1997;  26 654-658
  • 19 Modic M T, Feiglin D H, Piraino D W. et al . Vertebral osteomyelitis: assessment using MR.  Radiology. 1985;  157 157-166
  • 20 Morrison W B, Ledermann H P. Work-up of the diabetic foot.  Radiol Clin North Am. 2002;  40 1171-1192
  • 21 Morrison W B, Schweitzer M E, Batte W G, Radack D P, Russel K M. Osteomyelitis of the foot: relative importance of primary and secondary MR imaging signs.  Radiology. 1998;  207 625-632
  • 22 Morrison W B, Schweitzer M E, Bock G W. et al . Diagnosis of osteomyelitis: utility of fat-suppressed contrast-enhanced MR imaging.  Radiology. 1993;  189 251-257
  • 23 Paajanen H, Grodd W, Revel D, Engelstad B, Brasch R C. Gadolinium-DTPA enhanced MR imaging of intramuscular abscesses.  Magn Reson Imaging. 1987;  5 109-115
  • 24 Schiesser M, Stumpe K D, Trentz O, Kossmann T, Schulthess G K von. Detection of Metallic Implant-associated Infections with FDG PET in Patients with Trauma: Correlation with Microbiologic Results.  Radiology. 2003;  226 391-398
  • 25 Stumpe K D, Zanetti M, Weishaupt D. et al . FDG positron emission tomography for differentiation of degenerative and infectious endplate abnormalities in the lumbar spine detected on MR imaging.  AJR. 2002;  179 1151-1157
  • 26 Tumeh S S, Aliabadi P, Weissman B N, McNeil B J. Disease activity in osteomyelitis: role of radiography.  Radiology. 1987;  165 781-784
  • 27 Waldvogel F A, Medoff G, Swartz M N. Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects.  N Engl J Med. 1970;  282 198-206


Dr. med. Hans Peter Ledermann

Radiologisches Institut, Kantonsspital Basel

Petersgraben 4

CH-4031 Basel

Phone: +41 61 265 25 25

Fax: +41 61 373 88 08