Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico City, Mexico.
Semin Plast Surg. 2009 May;23(2):80-9. doi: 10.1055/s-0029-1214160.
The diagnostic imaging of osteomyelitis can require the combination of diverse imaging techniques for an accurate diagnosis. Conventional radiography should always be the first imaging modality to start with, as it provides an overview of the anatomy and the pathologic conditions of the bone and soft tissues of the region of interest. Sonography is most useful in the diagnosis of fluid collections, periosteal involvement, and surrounding soft tissue abnormalities and may provide guidance for diagnostic or therapeutic aspiration, drainage, or tissue biopsy. Computed tomography scan can be a useful method to detect early osseous erosion and to document the presence of sequestrum, foreign body, or gas formation but generally is less sensitive than other modalities for the detection of bone infection. Magnetic resonance imaging is the most sensitive and most specific imaging modality for the detection of osteomyelitis and provides superb anatomic detail and more accurate information of the extent of the infectious process and soft tissues involved. Nuclear medicine imaging is particularly useful in identifying multifocal osseous involvement.
骨髓炎的诊断影像学需要结合多种影像学技术，以做出准确的诊断。常规 X 线摄影应该始终是首先采用的影像学方式，因为它提供了感兴趣区域的骨骼和软组织的解剖和病理状况的全貌。超声检查在诊断积液、骨膜受累和周围软组织异常方面最有用，并且可以为诊断或治疗性抽吸、引流或组织活检提供指导。计算机断层扫描（CT）扫描是一种有用的方法，可以检测早期的骨质侵蚀，并记录死骨、异物或气体形成的存在，但一般来说，其对骨感染的检测敏感性低于其他方式。磁共振成像（MRI）是检测骨髓炎最敏感和最特异的影像学方式，提供了极好的解剖细节和更准确的感染过程和受累软组织的信息。核医学成像在识别多灶性骨受累方面特别有用。
