Radiologic Features of Osteomyelitis: Imaging Techniques and Findings

Introduction

Osteomyelitis is a serious bone infection that requires precise imaging for accurate diagnosis and management. Various imaging techniques help in detecting bone changes, monitoring disease progression, and guiding treatment.

Imaging Techniques

Plain Radiography (X-ray)

• First-line imaging tool.
• Detects bone destruction, periosteal reaction, and sclerosis.
• Limited sensitivity in early-stage osteomyelitis.

Magnetic Resonance Imaging (MRI)

• Highly sensitive for early detection.
• Identifies marrow edema, abscess formation, and soft tissue involvement.
• Preferred modality for evaluating chronic osteomyelitis.

Computed Tomography (CT)

• Useful for detailed cortical bone assessment.
• Helps in detecting sequestrum and involucrum.
• Often used in surgical planning.

Ultrasonography

• Detects periosteal elevation and soft tissue abscesses.
• Less commonly used for deep bone evaluation.

Nuclear Imaging (Bone Scan, PET)

• Detects infection and bone turnover.
• Useful in equivocal cases or post-treatment monitoring.

Radiologic Findings

• Acute Osteomyelitis: Soft tissue swelling, lytic lesions, and periosteal reaction.
• Chronic Osteomyelitis: Sequestrum, involucrum, and sinus tracts visible in advanced imaging.
• Post-Treatment Imaging: Resolution of infection, bone remodeling, and healing markers.

Conclusion

Imaging techniques play a vital role in diagnosing and managing osteomyelitis. Early detection through MRI and complementary modalities helps in improving patient outcomes.