Osteomyelitis: a review of currently used imaging techniques

Conventional radiographs remain the initial imaging modality involved in th e diagnosis of osteomyelitis. Bone scintigraphy and its specific agents did not only eliminate the problems of inherent low sensitivity of conventiona l radiographs, but also increased the specificity to higher degrees. Spiral CT, on the other hand, has solved several diagnostic problems, such as ost eomyelitis of the sterno-clavicular junction and hidden areas in the pelvic bones. Magnetic resonance imaging with its multiplanar capability, greater anatomic details and excellent soft tissue bone marrow contrast resolution has a significant role in surgical planning and limb preservation. Ultraso und and US-guided aspiration has recently been involved in the diagnosis an d management of osteomyelitis with several advantages particularly in child ren. Our goal in this review is to outline the ability of various imaging t echniques by comparing their strengths and weaknesses in the diagnosis of o steomyelitis. Finally, we suggest various imaging algorithms for specific c linical scenarios. Spondylitis and septic arthritis are not discussed in th is review.