The imaging features of acute osteomyelitis are well known to radiologists, but recognizing chronic osteomyelitis and differentiating active from inactive disease remains challenging. Chronic osteomyelitis typically occurs in the setting of open or instrumented fractures, often after a stormy clinical course. It may be quiescent for years and then flare into activity. Clinical decision making for debridement and route of antibiotic administration relies on accurate assessment of activity. The exhibit will illustrate imaging features of chronic osteomyelitis with tips for distinguishing active from inactive disease.
The natural history, clinical presentation and treatment of chronic osteomyelitis will be shown by case examples. The range of appearances of sequestra, involucra, cloacae, and sinus tracts will be illustrated on radiographs, and cross sectional images. Side-by-side comparison of chronic osteomyelitis on MRI and CT will show the relative value and pitfalls with each modality for detecting key features of active disease.
Distinguishing active from inactive chronic osteomyelitis can be
accomplished accurately with meticulous attention to specific but often overlooked findings that allow for confident differentiation.
Moore, S,
Evaluating Chronic Active and Inactive Osteomyelitis on Radiographs and Cross-sectional Images: Pearls and Pitfalls. Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL.
http://archive.rsna.org/2010/9004988.html
