Sinography in chronic fistulating osteomyelitis in sickle-cell anaemia

The sinographic appearances in 18 long bones of 14 consecutive patients with sickle-cell anaemia and chronic haematogenous osteomyelitis were studied prospectively; the observed features were compared with the plain radiographic and operative findings. Four sinographic patterns were noted: (1) infected bone cavities with or without sequestra; (2) extensive soft-tissue tracks, alone or in association with infected bone cavities; (3) narrow, wavy intramedullary tracks; (4) short sinus tracks in the soft tissue. Plain films were of no value in demonstrating the presence and extent of soft-tissue and narrow intramedullary tracks; they failed to show infected bone cavities in four instances because of very sclerotic bone. The sinographic features correlated well with the operative findings and contributed significantly to the choice of definitive treatment in 13 out of the 18 bones.