Osteomyelitis MRI

	Osteomyelitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Osteomyelitis from Other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications, and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Osteomyelitis MRI On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Osteomyelitis MRI All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Osteomyelitis MRI
CDC on Osteomyelitis MRI
Osteomyelitis MRI in the news
Blogs on Osteomyelitis MRI
Directions to Hospitals Treating Osteomyelitis
Risk calculators and risk factors for Osteomyelitis MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

MR imaging is the accepted modality of choice for the early detection and surgical localization of osteomyelitis.

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]
It 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, with fat appearing 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

↑ 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.