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CT and MRI evaluation of musculoskeletal infection
L D Ma1, F J Frassica, D A Bluemke
1Russell H. Morgan Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Abstract:
While the plain film and nuclear medicine bone scan are still the traditional imaging modalities used in the evaluation of musculoskeletal infection, the cross-sectional imaging modalities, computed tomography (CT) and magnetic resonance imaging (MRI), have become critical in the delineation of many types of musculoskeletal infection. In particular, the evaluation of soft tissue infections, including cellulitus, myositis, fasciitis, abscess, and septic arthritis are often best evaluated by MRI or CT due to their excellent anatomic resolution and soft tissue contrast. Even in osseous infection, CT and MRI can give better anatomic delineation of the extent of infection. In cases where the plain film and nuclear medicine bone scan findings are complicated due to previous surgery, trauma, or underlying illness, the anatomic resolution and soft tissue contrast provided by MRI and CT are often necessary to determine if underlying infection exists. MRI's visualization of the bone marrow allows for the sensitive detection of osteomyelitis, although specificity for the diagnosis of osteomyelitis is aided by other findings, including cortical destruction. The CT and MRI findings in the spectrum of musculoskeletal infections are discussed and contrasted, and pitfalls in their evaluation of musculoskeletal infection are described.
Insights
Computed tomography (CT) and magnetic resonance imaging (MRI) are crucial for diagnosing musculoskeletal infections, offering superior detail over traditional methods. These advanced imaging techniques effectively evaluate soft tissue infections and bone infections like osteomyelitis.
Area of Science:
- Radiology
- Musculoskeletal Imaging
- Infectious Disease Imaging
Background:
- Traditional imaging (plain film, nuclear medicine bone scan) has limitations in evaluating musculoskeletal infections.
- Cross-sectional imaging modalities are increasingly vital for accurate diagnosis and delineation.
Purpose of the Study:
- To highlight the critical role of computed tomography (CT) and magnetic resonance imaging (MRI) in musculoskeletal infection evaluation.
- To contrast the findings and discuss pitfalls of CT and MRI in diagnosing various musculoskeletal infections.
Main Methods:
- Review and discussion of computed tomography (CT) and magnetic resonance imaging (MRI) findings in musculoskeletal infections.
- Comparison of CT and MRI capabilities for soft tissue and osseous infections.
- Identification of potential pitfalls in interpreting imaging findings.
Main Results:
- CT and MRI provide superior anatomic resolution and soft tissue contrast compared to traditional methods.
- MRI is particularly sensitive for detecting osteomyelitis through bone marrow visualization.
- CT and MRI are essential for evaluating soft tissue infections (cellulitis, myositis, fasciitis, abscess, septic arthritis) and delineating the extent of osseous infection.
Conclusions:
- CT and MRI are indispensable tools for the comprehensive evaluation of musculoskeletal infections, especially when traditional methods are inconclusive due to complicating factors.
- These advanced imaging modalities offer enhanced diagnostic accuracy for both soft tissue and bone infections, including osteomyelitis.
- Understanding the specific findings and potential pitfalls of CT and MRI is crucial for effective clinical management.
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