RSS-Feed abonnieren
DOI: 10.1055/s-2004-835360
Imaging of Posttraumatic Osteomyelitis
Publikationsverlauf
Publikationsdatum:
11. Oktober 2004 (online)
![](https://www.thieme-connect.de/media/smr/200403/lookinside/thumbnails/10.1055-s-2004-835360-1.jpg)
Posttraumatic osteomyelitis frequently leads to an illness characterized by chronicity and recurrences. Bone changes themselves, developed during chronic infection, and orthopedic implants heavily influence the diagnostic value of the different imaging methods. Conventional radiography remains the cornerstone of imaging of acute and chronic osteomyelitis, but other modalities such as ultrasonography, radionuclide studies, computed tomography, and magnetic resonance imaging may be necessary. The values of the techniques in different clinical settings are described.
KEYWORDS
Osteomyelitis - trauma - magnetic resonance imaging - radiography
REFERENCES
- 1 Gross T, Kaim A H, Regazzoni P, Widmer A F. Current concepts in post-traumatic osteomyelitis: a diagnostic challenge with new imaging options. J Trauma. 2002; 52 1210-1219
- 2 Kaim A H, Gross T, von Schulthess G K. Imaging of chronic posttraumatic osteomyelitis. Eur Radiol. 2002; 12 1193-1202
- 3 Hardy A E, Nikol R O. Closed fractures complicated by hematogenous osteomyelitis. Clin Orthop. 1985; 201 190-195
- 4 Veranis N, Laliotis N, Vlachos E. Acute osteomyelitis complicating a closed radial fracture in a child. A case report. Acta Orthop Scand. 1992; 63 341-342
- 5 Nast-Kolb D, Scheiberer L. Treatment concept in infected bone and soft tissue damage [in German]. Orthopade. 1994; 23 430-436
- 6 Delling G. (1997) Skelettsystem. In: Pathology, V. Remmele W Springer Berlin; 297-304
- 7 Tsukayama D T. Pathophysiology of posttraumatic osteomyelitis. Clin Orthop. 1999; 360 22-29
- 8 Wickenhauser C, Tsironis K, Zirbes T K, Larena-Avellanda A, Dienes H P. Highly differentiated squamous epithelial carcinoma as a late complication of posttraumatic osteomyelitis [in German]. Pathologe. 1999; 20 236-241
- 9 Glaser C, Matzko M, Reiser M. Chronic infections of the skeletal system. Their imaging diagnosis. Radiologe. 2000; 40 547-556
- 10 Tumeh S S, Aliabadi P, Weissman B N, Mc Neil B J. Disease activity in osteomyelitis: role of radiology. Radiology. 1987; 165 781-784
- 11 Schauwecker D S, Park H M, Mock B H et al.. Evaluation of complicating osteomyelitis with Tc-99m MDP, In-111 granulocytes, and Ga-67 citrate. J Nucl Med. 1984; 25 849-853
- 12 Sciuk J, Erlemann R, Schober O, Peters P E. Diagnostic imaging in osteomyelitis. Dtsch Ärztebl. 1992; 89 2462-2473
- 13 Kolindou A, Lin Y, Ozker K et al.. In111WBC imaging of osteomyelitis in patients with underlying bone scan abnormalities. Clin Nucl Med. 1996; 21 183-191
- 14 Esterhai Jr J L, Goll S R, McCarthy K E et al.. Indium-111 leucocyte scintigraphic detection of subclinical osteomyelitis complicating delayed and non union bone fractures: a prospective study. J Orthop Res. 1987; 5 1-6
- 15 Kim E E, Pjura G A, Lowry P A. Osteomyelitis complicating fracture: pitfalls of 111In leukocyte scintigraphy. AJR Am J Roentgenol. 1987; 148 927-930
- 16 Seabold J E, Nepola J V, Conrad G R et al.. Detection of osteomyelitis at fracture nonunion sites: comparison of two scintigraphic methods. AJR Am J Roentgenol. 1989; 152 1021-1027
- 17 Turpin S, Lambert R. Role of scintigraphy in musculoskeletal and spinal infections. Radiol Clin North Am. 2001; 39 169-189
- 18 Leitha T. Nuclear medicine procedures for diagnosis of osteomyelitis. Radiologe. 1996; 36 813-822
- 19 Guhlmann A, Brecht-Krauss D, Suger G et al.. Flourine-18-FDG PET and technecium-99m antigranulocyte antibody scintigraphy in chronic osteomyelitis. J Nucl Med. 1998; 39 2145-2152
- 20 Riebel T W, Nasir R, Nazarenko O. The value of sonography in the detection of osteomyelitis. Pediatr Radiol. 1996; 26 291-297
- 21 Larcos G, Antico V F, Cormick W, Gruenewald S M, Farlow D C. How useful is ultrasonography in suspected acute osteomyelitis?. J Ultrasound Med. 1994; 13 707-709
- 22 Cardinal E, Bureau N J, Aubin B, Chhem R K. Role of ultrasound in musculoskeletal infections. Radiol Clin North Am. 2001; 39 191-201
- 23 Ledermann H P, Kaim A, Bongartz G, Steinbrich W. Pitfalls and limitations of MRI in chronic posttraumatic osteomyelitis. Eur Radiol. 2000; 10 1815-1823
- 24 Azouz E M, Raymond J. Intraosseous gas of the left tibia 24 hours after biopsy. Skeletal Radiol. 1985; 13 327-328
- 25 Tecce P N, Fishman E K. Spiral CT with multiplanar reconstruction in the diagnosis of sternoclavicular osteomyelitis. Skeletal Radiol. 1995; 24 275-281
- 26 Boutin R D, Brossmann J, Sartoris D J, Reilly D, Resnick D. Update on orthopaedic infections. Orthop Clin North Am. 1998; 29 41-66
- 27 Bitzer M, Schick F, Hartmann J et al.. MRI of osseous fistulous systems and sequesters in chronic osteomyelitis with standard spin echo sequences, highly selective chemical shift imaging, diffusion weighted imaging and magnetization transfer [German]. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 2002; 174 1422-1429
- 28 Mosher T J. Diagnostic effectiveness of Gadolinium-enhanced MR imaging in evaluation of abnormal bone marrow signal. Radiology. 2002; 224 320-322
- 29 Sanders T G, Medynski M A, Feller J F, Lawhorn K W. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics. 2000; 20 135-151
- 30 Kaim A, Ledermann H P, Bongartz G, Messmer P, Mueller-Brand J, Steinbrich W. Chronic posttraumatic 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
Karen-Helge BühneM.D.
Department of Radiology, Klinikum Augsburg
Stenglinstraße 2, 86156 Augsburg, Germany