ABSTRACT
The diagnostic imaging of osteomyelitis can require the combination of diverse imaging
techniques for an accurate diagnosis. Conventional radiography should always be the
first imaging modality to start with, as it provides an overview of the anatomy and
the pathologic conditions of the bone and soft tissues of the region of interest.
Sonography is most useful in the diagnosis of fluid collections, periosteal involvement,
and surrounding soft tissue abnormalities and may provide guidance for diagnostic
or therapeutic aspiration, drainage, or tissue biopsy. Computed tomography scan can
be a useful method to detect early osseous erosion and to document the presence of
sequestrum, foreign body, or gas formation but generally is less sensitive than other
modalities for the detection of bone infection. Magnetic resonance imaging is the
most sensitive and most specific imaging modality for the detection of osteomyelitis
and provides superb anatomic detail and more accurate information of the extent of
the infectious process and soft tissues involved. Nuclear medicine imaging is particularly
useful in identifying multifocal osseous involvement.
KEYWORDS
Osteomyelitis - computed tomography - magnetic resonance imaging - ultrasound - nuclear
medicine
REFERENCES
Bone and joint infections . In: Marx et al Rosen's Emergency Medicine: Concepts and Clinical Practice. New York,
NY; Mosby 2006 Osteomyelitis, septic arthritis and soft tissue infection: mechanisms and situations . In: Resnick D Diagnosis of Bone and Joint Disorders. 3rd ed. Philadelphia, PA; WB
Saunders 1995: 2325-2418
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