What is Potts disease? Pott’s disease of the spine is tuberculous spondylitis. Like pyogenic (bacterial) spondylitis, it can affect one or more vertebral bodies. Unlike bacterial discitis-osteomyelitis, however, Mycobacterium tuberculosis typically causes less disc space destruction than pyogenic infection, often spreading along the longitudinal ligaments of the spine to affect several vertebral bodies with relative preservation of …
What is the radiographic and MRI appearance of infectious spondylitis? Infectious spondylitis, often called “discitis-osteomyelitis,” is infection of the spine. In adults, the appearance is similar to the manifestations of septic arthritis: destruction, enhancement, and an effusion of at least one disc space and findings of acute osteomyelitis of the adjacent vertebral bodies. In children, …
Radiographic and MRI appearance of infectious spondylitis Read More »
Are there any imaging findings that are suggestive of septic arthritis? Yes. The findings of a large complex joint effusion with thick synovial enhancement and bone marrow edema in the bones surrounding the joint raise suspicion for septic arthritis, particularly when only one joint is involved. Periarticular osteopenia, uniform joint space narrowing, osseous erosions, and …
Are there any imaging findings that are suggestive of septic arthritis Read More »
What imaging study is ordered in a patient with suspected septic arthritis? None, or at most any cross-sectional imaging study to confirm the presence of a joint effusion. No imaging study has sufficient sensitivity to fully exclude this important diagnosis. If septic arthritis is suspected, then the only way to exclude joint space infection is …
What is the role of intravenous contrast material in the diagnosis of soft tissue infection? Contrast material is helpful to delineate the presence and extent of soft tissue infection. In particular, it is often necessary to diagnose an abscess or other organized fluid collection. Although large abscesses or hematomas can be identified on unenhanced images, …
Role of intravenous contrast material in the diagnosis of soft tissue infection Read More »
How does the diagnosis of osteomyelitis differ in patients with Charcot arthropathy (neuropathic joint)? Patients with neuropathic arthropathy of Charcot have preexisting joint space destruction, bony fragmentation, and bone marrow edema—findings that would otherwise raise suspicion for osteomyelitis. However, both Charcot arthropathy and osteomyelitis are often coexistent, particularly in patients with advanced diabetes mellitus. Therefore, …
How does the diagnosis of osteomyelitis differ in patients with Charcot arthropathy Read More »
Is intravenous contrast material necessary for the diagnosis of acute osteomyelitis by MRI? No. In general, the diagnosis is established based on a combination of bone marrow edema, ancillary findings such as skin ulceration, and clinical history. Contrast material can occasionally be helpful in evaluating the pattern of bone marrow enhancement. However, MRI contrast is …