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Congress: ECR24
Poster Number: C-13238
Type: EPOS Radiologist (educational)
DOI: https://dx.doi.org/10.26044/ecr2024/C-13238
Authorblock: A. Salgado-Parente, A. Michael-Fernández, E. Antolinos Macho, A. González Huete, M. D. López-Parra, N. Arévalo Galeano, J. Acosta Batlle; Madrid/ES
Disclosures:
MD Alba Salgado-Parente: Nothing to disclose
Dr. Antonio Michael-Fernández: Nothing to disclose
Dr. Elisa Antolinos Macho: Nothing to disclose
Dr. Abel González Huete: Nothing to disclose
Mrs M Dolores López-Parra: Nothing to disclose
Dr. Noelia Arévalo Galeano: Nothing to disclose
Dr. Jose Acosta Batlle: Nothing to disclose
Keywords: Musculoskeletal bone, Musculoskeletal spine, Musculoskeletal system, Conventional radiography, CT, MR, Biopsy, Infection
Learning objectives This exhibit will: Describe the pathophysiology of Osteomyelitis (OM) through a pictorial review. Review the different imaging findings of OM on US, CT, MR and PET-CT. Discuss the main differential diagnosis of OM with main focus on key points and pitfalls. 
Read more Background Osteomyelitis (OM) is defined as an infection of the bone marrow and adjacent osseous structures with potential surrounding soft tissue extent. Staphylococcus aureus is the causative organism in up to 80% of cases [1,2]. Clinical symptoms include fever, malaise, localized pain, swelling and redness, although they may be minimal or absent [1,3].Three main routes for the spread of OM have been described: Haematogenous spread (most frequent in children): Blood-borne organisms are deposited in the medullary cavity and form a nidus of...
Read more Findings and procedure details A. IMAGING FINDINGSGiven the potential lack of specific symptoms and laboratory test results, diagnostic imaging plays a crucial role in many patients. Indications and disadvantages of the different imaging techniques are summarized in Table 1.  [fig 1] 1. Conventional radiography (CR)The technique of choice for initial evaluation is conventional radiography. Radiographs lag behind onset of infection by 10-14 days; during this period, only soft tissue swelling and osteoporosis can be seen. (Figure 5)Tip: The first step is to consider the differential diagnosis of...
Read more Conclusion Conventional radiography is the initial step in diagnosing OM. Although if it is normal, it shouldn't deter further evaluation MRI, assessing of both bone and soft tissue, is the preferred imaging method for OM Intravenous gadolinium is recommended unless contraindicated The diagnosis of musculoskeletal infections often poses a challenge for the radiologist. It is crucial to be aware of alternative differential diagnoses to avoid morbidity.
Read more References Desimpel, J., Posadzy, M. and Vanhoenacker, F.M., 2017. The Many Faces of Osteomyelitis: A Pictorial Review. Journal of the Belgian Society of Radiology, 101(1), p.24. Jaramillo D, Dormans JP, Delgado J, Laor T, St Geme JW 3rd. Hematogenous osteomyelitis in infants and children: Imaging of a changing disease. Radiology. 2017; Jun;283(3):629-643. Lee YJ, Sadigh S, Mankad K, Kapse N, Rajeswaran G. The imaging of osteomyelitis. Quant Imaging Med Surg. 2016 Apr;6(2):184-98. Soldatos T, Durand DJ, Subhawong TK, Carrino JA, Chhabra A. Magnetic resonance...
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