2. To demonstrate focal or multifocal sites of
infection
To demonstrate the location
To see the extent of infection
To identify drainable collection
To see complications
To suggest appropriate imaging modality
3. Infection of the bone marrow and adjacent
osseous structures with potential
surrounding soft tissue extent
4. Sign and symptoms(children) ---acute
Fever
Swelling or pain
Decreased range of movement of affected
limb
Focal tenderness
Adult—clinical onset is more insidious
5. Laboratory
Increased C-reactive protein
Increased erythrocyte sedimentation rate(ESR)
WBC—could be normal or increased
8. 1. Hematogenous---children
2. Non hematogenous(from contiguous source
of infection)--adult
Open fracture
Post operative infection
Foreign bodies
NB:- Osteomyelitis could also be from chronic
vascular insufficiency(Diabetes Mellitus)
11. Radiological sign depends on age of patient,
metaphyseal and epiphyseal blood supply
Intraarticular and extraarticular location of
the physeal(growth) plate.
Early diagnosis of the osteomyelitis is crucial
for early initiation of treatment
Late diagnosis leads to complication
15. The most common initial focus of infection in
children is metaphysis of long bone
In rare cases the focus could be epiphyseal
(through circulus articuli vasculosus of
Hunter)
21. Radiography(X-ray)
Magnetic Resonance Imaging(MRI)
Ultrasound(Sonography)
Bone scintigraphy
Computed Tomography(CT)
22. The initial modality of choice
Dictate subsequent imaging modality
Diagnostic in less than 20% of acute
osteomyelitis caused by Staph aurous
Radiographic sign is seen after 10days of
onset of infection
23. Has excellent soft tissue contrast
Detects infection after 3-5days of onset of
infection.
A pathognomonic sign for acute osteomyelitis
is the presence of intramedullary fat globules
on T1W.
Penumbra sign on T1W is pathognomonic for
intramedullary abscess collection.
24.
25.
26. It detect signs of osteomyelitis earlier than
plain radiography
Has doppler studies to assess
Detects complications of osteomyelitis
(pyomyositis, vein thrombosis, subperiosteal
abscess)
It allow dynamic evaluation
Allows easy comparison of both sides.
27.
28. Highly sensitive but less specific
Detects osteomyelitis in less than 48 hrs
Used to detect multifocal lesions.
31. Characterized by presence of Brodies abscess
Oval radiolucent lesion with peripheral band
of sclerosis
Commonly located in long bones(metaphysis)
Short and flat bones—rare
MRI-Penumbra sign(peripheral rim of T1W
hyperintensity around the pus collection)
32.
33. Inhomogeneous osteosclerosis
Sequestrum formation
Involucrum
Cloaca (opening in the involucrum)
Soft tissue sinus tract(tracking from bone to
skin)
CT is imaging modality of choice for
evaluating chronic osteomyelitis
