A radiological analysis of chronic sclerosing osteomyelitis of the mandible.

OBJECTIVE

To determine the frequency of specific characteristics of chronic sclerosing osteomyelitis (CSO) of the mandible in plain films compared with CT scans.

METHODS

After calibration, three observers studied 13 cases of plain films and 11 sets of separated and masked CT scans from the same cases. Controls consisted of cases of fibro-osseous disease with a similar appearance. Comparison with the results of nuclear scans of eight of the cases was made.

RESULTS

Periosteal new bone formation, sclerosis and bone enlargement were the most common characteristics. When the CT scans were analysed, detection of sequestra improved from 45 to 91%. There was greater agreement between observers when analysing CT scans compared with plain films. The results of the gallium scans supported the diagnosis in only two of the eight cases.

CONCLUSION

In this study, the CT scans were the most reliable imaging method for revealing characteristics such as sequestra which are useful for the diagnosis of CSO.