Diagnostic imaging of musculoskeletal infectious diseases

Abstract

Radiographs followed by magnetic resonance imaging (MRI) are the first-choice modality for pediatric osteomyelitis imaging. Imaging aims to diagnose the presence and extent of osteomyelitis, assess the need for debridement of abscesses, evaluate risk factors, such as lesions extending the growth plate that may lead to growth disturbances, and determine the presence of complications, such as thrombosis and ischemia. It is essential to understand the anatomical and physiological characteristics of developing bones and tailor MRI protocols according to age. Key points in image interpretation include the differences between acute bacterial osteomyelitis, such as that caused by staphylococcus, and osteomyelitis caused by low-virulence bacteria, such as mycobacterium, as well as imaging features of subacute and chronic osteomyelitis. Growth disturbances as late complications are a significant concern in pediatric osteomyelitis, highlighting the need for an accurate early diagnosis.