[Osteomyelitis--imaging methods and their value]

Area of Science:

• Medical Imaging
• Infectious Diseases
• Orthopedics

Background:

• Osteomyelitis and ostitis diagnosis relies on imaging modalities to detect pathophysiological changes in bone and soft tissue.
• Plain film radiography reveals changes only in advanced disease stages, serving basic and follow-up roles.
• Ultrasound aids acute osteomyelitis diagnosis, particularly in infants.

Purpose of the Study:

• To review and compare various imaging modalities for diagnosing infectious bone and soft tissue diseases.
• To highlight the strengths and limitations of each imaging technique in detecting osteomyelitis and ostitis.

Main Methods:

• Review of diagnostic imaging modalities including plain film radiography, ultrasound, nuclear medicine, computed tomography (CT), and magnetic resonance imaging (MRI).
• Discussion of the application and effectiveness of each modality in identifying infectious changes in bone and surrounding soft tissues.

Main Results:

• Plain film radiography is limited to advanced stages but useful for differential diagnosis and therapy monitoring.
• Nuclear medicine techniques show high sensitivity but poor spatial resolution for differentiating bone and soft tissue involvement.
• Computed tomography (CT) visualizes bone and soft tissue separately but has been largely superseded by MRI.
• Magnetic resonance imaging (MRI), especially with fat-suppressed sequences and contrast media, demonstrates superior sensitivity and accuracy in depicting infectious spread.

Conclusions:

• MRI is the most sensitive and accurate modality for diagnosing osteomyelitis and ostitis, effectively visualizing infectious changes in both bone and soft tissues.
• While other modalities have specific roles, MRI represents the current standard for comprehensive assessment of these infections.