Chronic osteomyelitis with epidural abscess: CT and MR findings

A case of chronic osteomyelitis in the occipital bone associated with underlying chronic epidural abscess was diagnosed by skull radiography, CT, and MR. Skull radiography showed diffuse sclerosis of the occipital bone and dural calcifications. Computed tomography demonstrated thickened sclerotic changes of the osteomyelitic area, dural calcifications, and epidural fluid collection. The area of chronic osteomyelitis displayed, essentially, no signal intensity in the T1-weighted and T2-weighted MR images. The chronic epidural abscess had heterogeneous signal intensity on T1-weighted images and good enhancement after Gd-diethylenetriamine pentaacetic acid administration. On T2-weighted images the abscess had relatively homogeneous high signal intensity.