Magnetic resonance imaging: application in musculoskeletal infection

Forty-two patients with clinically suspected osteomyelitis were examined using magnetic resonance imaging (MRI). Twenty-seven patients (64%) had previous surgery or fracture, and 15 (36%) were referred for differentiation of acute osteomyelitis from bone tumors or other pathologic conditions. MRI was compared with computed tomography in 12 cases and with 111In-labeled leukocytes scans in 22. With MRI, 92% of proved infections were detected, and bone and soft-tissue changes were more evident than with routine radiographs, tomography, or computed tomography. In patients with negative cultures and no previous surgery or fracture, it was difficult for MRI to differentiate operative changes from infection. In these patients, 111In-labeled leukocyte images were more specific than MRI.