Osteomyelitis imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Imaging Findings

Diagnosis of osteomyelitis is often based on radiologic results showing a lytic center with a ring of sclerosis, though bone cultures are normally required to identify the specific pathogen.

  • Conventional radiographic evaluation of acute osteomyelitis is insufficient because bone changes are not evident for 14–21 days after the onset of infection.
  • Although MR imaging is the accepted modality of choice for the early detection and surgical localization of osteomyelitis, in the emergency department, CT is usually more readily available for establishing the diagnosis. [1]
  • At CT, features of bacterial osteomyelitis include overlying soft-tissue swelling, periosteal reaction, medullary low-attenuation areas or trabecular coarsening, and focal cortical erosions.

MRI

Images courtesy of RadsWiki

Patient #1 Extensive calcaneal osteomyelitis. Note soft tissue ulceration and cellulitis

Bone Scan

Patient #2

Images courtesy of RadsWiki


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References

  1. Laura M. Fayad, John A. Carrino, and Elliot K. Fishman. Musculoskeletal Infection: Role of CT in the Emergency Department. RadioGraphics 2007 27: 1723-1736.


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