Chronic complicated osteomyelitis of the lower extremity: evaluation with MR imaging

Preoperative magnetic resonance (MR) imaging examinations were performed with a 1.5-T superconducting magnet in 14 patients who had extensive deformities of the bones and soft tissues of the lower extremities due to previous trauma, surgery, and chronic infection. This retrospective study assessed the diagnostic performance of MR imaging in determining the presence and extent of active bone and soft-tissue infections. The presence and extent of active osteomyelitis were confirmed by reviewing the clinical, surgical, histologic, and microbiologic records of all patients. Of the 14 MR imaging examinations, 11 were true-positive, two were true-negative, one was false-positive, and none was false-negative. In the indium scans obtained in this group of patients, five were true-positive, three were true-negative, none was false-positive, and three were false-negative. In two amputated extremities, close correlation was found between the extent of disease seen on surgical and pathologic examination and that demonstrated by MR imaging, which could delineate the course of sinus tracts. MR imaging was therefore helpful in assessing the activity of chronic complicated osteomyelitis and beneficial in surgical planning for these patients.