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Radiography of pressure ulcers
P S Borgström1, O Ekberg, A Lasson
1Department of Diagnostic Radiology, Malmö Allmanna Sjukhus, University of Lund, Sweden.
Acta Radiologica (Stockholm, Sweden : 1987)
|September 1, 1988
Summary
Radiography can detect bone infection in pressure ulcers, but cannot distinguish active from healed osteomyelitis. Sinography is useful for identifying joint involvement, aiding surgical planning for pressure ulcer patients.
Area of Science:
- Orthopedics
- Radiology
- Infectious Disease
Background:
- Deep and longstanding pressure ulcers often require radiological assessment.
- Osteomyelitis is a common complication in patients with pressure ulcers.
Purpose of the Study:
- To evaluate the utility of survey radiography and sinography in assessing bone and joint involvement in patients with pressure ulcers.
- To determine the effectiveness of these imaging modalities in preoperative planning for surgical interventions.
Main Methods:
- Retrospective review of 14 patients with pressure ulcers (tuber ischii and femoral trochanter).
- Analysis of survey radiography and sinography findings.
- Correlation of imaging results with clinical outcomes and surgical planning.
Main Results:
- Survey radiography identified osteomyelitis in 9 out of 14 patients.
- Distinguishing active from healed osteomyelitis was challenging with survey radiography.
- Sinography did not effectively assess cortical bone involvement but was valuable in detecting fistulation to adjacent joints.
- Joint involvement identified by sinography significantly aided preoperative planning for resection.
Conclusions:
- Survey radiography and sinography are valuable tools in evaluating pressure ulcers with suspected bone or joint involvement.
- Radiological findings, particularly joint involvement, must be critically evaluated for effective surgical planning.
- Prompt recognition and management of septic arthritis secondary to pressure ulcer fistulation are crucial due to rapid progression.