Osteomyelitis: detection with US. Work in progress

Ten patients with clinically suspected osteomyelitis were studied with ultrasound (US). Five patients had abnormalities detectable on sonograms. An abnormal fluid collection was demonstrated adjacent to the bone in three of these five. US-guided aspiration of the fluid in two of the three patients revealed purulent or infected fluid that was thought to represent an inflammatory exudate dissecting in a subperiosteal or extraperiosteal location. Findings from subsequent radiographic and scintigraphic studies confirmed the diagnosis of osteomyelitis in these three patients. The other two patients with abnormal sonographic results had collections of fluid that were separated from the bone by a variable amount of soft tissue. These collections were confined to the soft tissue and did not appear to arise from the bone. Aspiration revealed a soft-tissue abscess in one patient and a seroma in the second. Findings in this preliminary study suggest that fluid around the bone seen on sonograms may indicate acute osteomyelitis.