RADIOGRAPHIC PATTERNS OF OSTEOMYELITIS IN THE MANDIBLE PLAIN FILM CT CORRELATION

Mandibular osteomyelitis often is associated with involvement of the m asticator space. Assessment of mandibular osteomyelitis should therefo re involve assessment of soft tissue involvement of the lesion. The pu rpose of this study was to clarify the relationship between computed t omography patterns and the presence of inflammation in soft tissues. T hirty-three cases diagnosed with osteomyelitis of the mandible were an alyzed radiologically-with conventional radiographs and with computed tomography scans. Computed tomography patterns of osteomyelitis were c lassified into four types, lytic, mixed, sclerotic, and sequestrum pat terns. Location, extent of the lesion, and change of the cortical plat e were evaluated and compared with conventional radiographic findings. Mixed pattern cases displayed diffuse bone abnormalities, which somet imes were accompanied by cortical plate disruption and periosteal reac tion. In addition, most mixed pattern cases showed soft tissue involve ment, especially of the masseter muscle. Inflammation of the masseter muscle was found to be related to periosteal reaction and disruption o f the buccal cortical plate. The data demonstrate a close interaction between cortical plate disruption and muscle inflammation. The extent of inflammation including soft tissue involvement was better appreciat ed with computed tomography in osteomyelitis, especially in mixed patt ern cases.