December 2013

Start Page: 18

   Dr. Lullove notes a computed tomography (CT) scan is not as specific as MRI for osteomyelitis and plain film radiography will show osteolytic processes, but well after the infection process is beyond 14 to 21 days from the onset. He says one can utilize ultrasonography to see periosteal reactions and violations of the cortex in areas where one can use sonographic imaging effectively.

   Although some studies recommend the routine use of gadolinium, Dr. Lullove notes that others suggest that it is unnecessary. "There is no convincing evidence that contrast improves the diagnostic accuracy for osteomyelitis, but it is clear that its use improves the evaluation of soft tissue pathology as it helps to demonstrate abscesses and sinus tracts more easily. The use of contrast may also allow differentiation of viable from non-viable bone or soft tissue," he notes.

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