Imaging evaluation of osteomyelitis

Bone infection, or osteomyelitis, is a common medical problem that is often difficult to diagnose. Osteomyelitis is not unusual in diabetic patients with foot ulcers and bedridden patients with decubitus ulcers--populations where diagnosis is especially difficult. Spinal osteomyelitis and septic arthritis require early diagnosis in order to avoid permanent debilitating consequences. Regardless of the clinical setting, imaging plays an important role in establishing the diagnosis and directing treatment. A variety of imaging modalities may be used, including plain radiography, radionuclide imaging, computed tomography (CT), and magnetic resonance imaging (MRI). Decisions regarding the best imaging modality can be challenging and should reflect the location of the suspected infection and associated illness or bony disorders.