Osteomyelitis MRI: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Osteomyelitis}} | {{Osteomyelitis}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{MehdiP}} | ||
==Overview== | ==Overview== | ||
MRI is the accepted modality of choice for the early detection and surgical localization of osteomyelitis. | |||
==MRI== | ==MRI== | ||
*MRI is more sensitive than CT or radionuclide imaging in acute osteomyelitis and is the best radiographic imaging technique for identifying abscesses and for differentiating between bone and soft tissue infection.<ref name="pmid17118291">{{cite journal |vauthors=Pineda C, Vargas A, Rodríguez AV |title=Imaging of osteomyelitis: current concepts |journal=Infect. Dis. Clin. North Am. |volume=20 |issue=4 |pages=789–825 |year=2006 |pmid=17118291 |doi=10.1016/j.idc.2006.09.009 |url=}}</ref> | *MRI is more sensitive than CT or [[radionuclide]] imaging in acute osteomyelitis and is the best radiographic imaging technique for identifying abscesses and for differentiating between bone and soft tissue infection.<ref name="pmid17118291">{{cite journal |vauthors=Pineda C, Vargas A, Rodríguez AV |title=Imaging of osteomyelitis: current concepts |journal=Infect. Dis. Clin. North Am. |volume=20 |issue=4 |pages=789–825 |year=2006 |pmid=17118291 |doi=10.1016/j.idc.2006.09.009 |url=}}</ref> | ||
* | *MRI provides precise anatomic detail of [[subperiosteal]] pus and accumulation of purulent debris in the bone marrow and [[metaphysis]], for possible surgical intervention. In acute osteomyelitis, [[purulent]] debris and [[edema]] appear dark, with decreased signal intensity on T1- weighted images, while fat appear bright.<ref name="pmid19380545">{{cite journal |vauthors=Averill LW, Hernandez A, Gonzalez L, Peña AH, Jaramillo D |title=Diagnosis of osteomyelitis in children: utility of fat-suppressed contrast-enhanced MRI |journal=AJR Am J Roentgenol |volume=192 |issue=5 |pages=1232–8 |year=2009 |pmid=19380545 |doi=10.2214/AJR.07.3400 |url=}}</ref> | ||
*In T2 weighted images, the signal from fat is diminished with fat suppression techniques to enhance visualizaton. | *In T2 weighted images, the signal from fat is diminished with [[fat]] suppression techniques to enhance visualizaton. | ||
*Gadolinium administration can enhance MRI resolution and increase the diagnostic yield. | *Gadolinium administration can enhance MRI resolution and increase the diagnostic yield. | ||
*Gadolinium becomes localized in areas of increased vascularity and blood flow and also helps distinguish soft tissue infections such as abscesses and cellulitis from osteomyelitis. | *[[Gadolinium]] becomes localized in areas of increased [[vascularity]] and blood flow and also helps distinguish soft tissue infections such as [[abscesses]] and cellulitis from osteomyelitis. | ||
*Cellulitis and sinus tracts appear as areas of high signal intensity on T2-weighted images.<ref name="pmid19794219">{{cite journal |vauthors=Copley LA |title=Pediatric musculoskeletal infection: trends and antibiotic recommendations |journal=J Am Acad Orthop Surg |volume=17 |issue=10 |pages=618–26 |year=2009 |pmid=19794219 |doi= |url=}}</ref> | *[[Cellulitis]] and sinus tracts appear as areas of high signal intensity on T2-weighted images.<ref name="pmid19794219">{{cite journal |vauthors=Copley LA |title=Pediatric musculoskeletal infection: trends and antibiotic recommendations |journal=J Am Acad Orthop Surg |volume=17 |issue=10 |pages=618–26 |year=2009 |pmid=19794219 |doi= |url=}}</ref> | ||
*Osteomyelitis produces a diminished intensity of the normal marrow signal on T1-weighted images and a normal or increased signal on T2-weighted images.<ref name="pmid17762382">{{cite journal |vauthors=Lalam RK, Cassar-Pullicino VN, Tins BJ |title=Magnetic resonance imaging of appendicular musculoskeletal infection |journal=Top Magn Reson Imaging |volume=18 |issue=3 |pages=177–91 |year=2007 |pmid=17762382 |doi=10.1097/RMR.0b0318123eee56 |url=}}</ref> | *Osteomyelitis produces a diminished intensity of the normal marrow signal on T1-weighted images and a normal or increased signal on T2-weighted images.<ref name="pmid17762382">{{cite journal |vauthors=Lalam RK, Cassar-Pullicino VN, Tins BJ |title=Magnetic resonance imaging of appendicular musculoskeletal infection |journal=Top Magn Reson Imaging |volume=18 |issue=3 |pages=177–91 |year=2007 |pmid=17762382 |doi=10.1097/RMR.0b0318123eee56 |url=}}</ref> | ||
[[Image:OMgif2.gif|500px|thumb|left| | ===MRI with fat suppression T2-weighted=== | ||
[[Image:OMgif2.gif|500px|thumb|left|The red arrows indicate the right femoral head with intramedullary collection; the white arrows indicate surrounding inflammatory muscle swelling]] | |||
<br style="clear:left;" /> | <br style="clear:left;" /> | ||
[[Image:OMgif3.gif|500px|thumb|left| | ===T1 MRI with Gadolinium=== | ||
[[Image:OMgif3.gif|500px|thumb|left|The yellow circle shows bone resorption and lytic lesion in left femoral head]] <div style="clear:both"></div> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{Category:Infectious disease}} | |||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Orthopedics]] | |||
Latest revision as of 23:28, 29 July 2020
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Osteomyelitis MRI On the Web |
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American Roentgen Ray Society Images of Osteomyelitis MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
MRI is the accepted modality of choice for the early detection and surgical localization of osteomyelitis.
MRI
- MRI is more sensitive than CT or radionuclide imaging in acute osteomyelitis and is the best radiographic imaging technique for identifying abscesses and for differentiating between bone and soft tissue infection.[1]
- MRI provides precise anatomic detail of subperiosteal pus and accumulation of purulent debris in the bone marrow and metaphysis, for possible surgical intervention. In acute osteomyelitis, purulent debris and edema appear dark, with decreased signal intensity on T1- weighted images, while fat appear bright.[2]
- In T2 weighted images, the signal from fat is diminished with fat suppression techniques to enhance visualizaton.
- Gadolinium administration can enhance MRI resolution and increase the diagnostic yield.
- Gadolinium becomes localized in areas of increased vascularity and blood flow and also helps distinguish soft tissue infections such as abscesses and cellulitis from osteomyelitis.
- Cellulitis and sinus tracts appear as areas of high signal intensity on T2-weighted images.[3]
- Osteomyelitis produces a diminished intensity of the normal marrow signal on T1-weighted images and a normal or increased signal on T2-weighted images.[4]
MRI with fat suppression T2-weighted
T1 MRI with Gadolinium
References
- ↑ Pineda C, Vargas A, Rodríguez AV (2006). "Imaging of osteomyelitis: current concepts". Infect. Dis. Clin. North Am. 20 (4): 789–825. doi:10.1016/j.idc.2006.09.009. PMID 17118291.
- ↑ Averill LW, Hernandez A, Gonzalez L, Peña AH, Jaramillo D (2009). "Diagnosis of osteomyelitis in children: utility of fat-suppressed contrast-enhanced MRI". AJR Am J Roentgenol. 192 (5): 1232–8. doi:10.2214/AJR.07.3400. PMID 19380545.
- ↑ Copley LA (2009). "Pediatric musculoskeletal infection: trends and antibiotic recommendations". J Am Acad Orthop Surg. 17 (10): 618–26. PMID 19794219.
- ↑ Lalam RK, Cassar-Pullicino VN, Tins BJ (2007). "Magnetic resonance imaging of appendicular musculoskeletal infection". Top Magn Reson Imaging. 18 (3): 177–91. doi:10.1097/RMR.0b0318123eee56. PMID 17762382.