Musculoskeletal Infection

Musculoskeletal Infection
Thomas H. Berquist
Basic Concepts
TABLE 11-2 COMMON ORGANISMS IN MUSCULOSKELETAL INFECTIONS
Bacterial InfectionsGram-positive  Staphylococcal  Streptococcal  Meningococcal  GonococcalGram-negative bacilli  Coliform bacterial infections  Proteus  Pseudomonas  Klebsiella  Salmonella  Haemophilus  BrucellaMycobacteria  Tuberculosis  Atypical mycobacteria
Fungal and Higher Bacterial Infections  Actinomycosis  Nocardiosis  Cryptococcosis  Coccidioidomycosis  Histoplasmosis  Sporotrichosis
Parasitic Infections  Hookworms  Cysticercosis  Echinococcosis
Suggested Reading
Berquist TH, Broderick DF. Musculoskeletal infections. In: Berquist TH, ed. MRI of the musculoskeletal system, 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2006:916–947.
Resnick D. Osteomyelitis, septic arthritis, and soft tissue infection: Mechanisms and situations. In: Resnick D. Diagnosis of bone and joint disorders, 4th ed. Philadelphia: WB Saunders; 2002:2510–2624.
Osteomyelitis
TABLE 11-3 IMAGING APPROACHES FOR OSTEOMYELITIS
Radiographic Features Next Steps
Positive Biopsy and treat
Negative; low suspicion Technetium scan:
—Negative: stop
—Positive: MRI or combined radionuclide studies
Negative; high suspicion Combined radionuclide studies and/or MRI
MRI, magnetic resonance imaging.
FIGURE 11-1 The vascular supply to the metaphysis and epiphysis in infants (A), children (B), and adults (C). The physis serves a protective function for the epiphysis from ages 1 to 16 years (B).
FIGURE 11-2 Anteroposterior (AP) radiograph demonstrating the characteristic appearance of osteomyelitis with a lytic lesion in the metaphysis (arrow) and periosteal reaction along the fibula (arrowheads).
Suggested Reading
Bonakdapour A, Gaines VD. The radiology of osteomyelitis. Orthop Clin North Am 1983;14:21–37.
Gold RH, Hawkins RA, Katz BD. Bacterial osteomyelitis: Findings on plain film, CT, MRI, and scintigraphy. AJR Am J Roentgenol 1991;157:365–370.
Chronic Recurrent Multifocal Osteomyelitis
FIGURE 11-3 Axial CT (A) and T1-weighted MR (B) images demonstrate thickening and sclerosis of the medial clavicles and sternocostal junctions.
Suggested Reading
Demharter J, Bohndorf K, Michl W, et al. Chronic recurrent multifocal osteomyelitis: Radiological and clinical investigation in 5 cases. Skel Radiol 1997;26:579–588.

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Jul 27, 2016 | Posted by in MUSCULOSKELETAL IMAGING | Comments Off on Musculoskeletal Infection

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