Current imaging concepts in pediatric osteomyelitis (original) (raw)

Discordance between MRI and bone scan findings in a child with acute complicated osteomyelitis: scintigraphic features that contribute to the early diagnosis

Revista española de medicina nuclear e imagen molecular

Early diagnosis and prompt treatment of acute osteomyelitis are of paramount importance in children because they can prevent irreversible bone damage. Magnetic resonance imaging (MRI) with its superior spatial resolution and lack of ionizing radiation is routinely preferred over bone scan for this purpose. Increased blood flow, hyperemia and focally increased tracer uptake shown by "three phase" bone scan are the typical scintigraphic findings of acute osteomyelitis. In addition, diffuse uptake along the shaft of long bones and focal "cold" lesions are two special features that may be highly suggestive of infective periostitis, soft tissue sepsis and subperiosteal abscess formation, due to the loose attachment of periosteum to bone during childhood. We present a case of complicated osteomyelitis in a child with inconclusive MRI correctly diagnosed on the basis of these special scintigraphic findings resulting in treatment change from double i.v. Vancomycin--Ceftr...

Utility of magnetic resonance imaging in the follow-up of children affectedby acute osteomyelitis

Current Pediatric Research, 2017

Acute osteomyelitis is characterized, especially in children, by high morbidity due to extension of the infectious process or its chronicization. No guidelines exist for the postdischarge follow-up of children affected by acute osteomyelitis, especially regarding the utility of magnetic resonance imaging (MRI). To investigate if MRI is useful in the follow-up of AO pediatric patients. We reviewed medical records and MRI studies of children admitted to our Pediatric Department for acute osteomyelitis from 2008 to 2015. All children who had a follow-up MRI performed at least 10 days after diagnosis were included in the study. We analyzed if MRI follow-up prompted a change in patients’ treatment. A total of 28 MRI studies were performed in 27 children (13 males and 14 females). Infection involved the appendicular skeleton in 64.3% of patients. Five (18%) of these studies prompted a change in patients’ treatment. The only statistically significant indication for change in the therapeuti...

Sequential MR Images and Radiographs of Epiphyseal Osteomyelitis in the Distal Femur of an Infant

Case Reports in Radiology, 2013

Magnetic resonance imaging (MRI) plays an important role in the diagnosis of osteomyelitis, especially during the early phase of the disease. The findings of sequential MRIs during the course of treatment in acute osteomyelitis in children have not yet been reported in the literature. We present a case of acute epiphyseal osteomyelitis in the distal femur of an infant. We monitored imaging changes by sequential MRIs and radiographs. MRI was more useful than radiograph for early diagnosis and evaluation of therapeutic response.