Radiologic and CT-semiotics of hematogenous osteomyelitis consequences of the knee bones

Abstract

Purpose. Studying the knee changes in patients with hematogenous osteomyelitis consequences on the basis of modern methods of radiation diagnostics and the developed evaluation complex of parameters.
Materials and Methods. 41 patients with the consequences of hematogenous osteomyelitis of the knee bones at the age of 5-31 years examined by the method of multi-position radiography. Multispiral computed tomography performed in 23 patients.
Results. Radiological examination of the knee performed in all patients on admission demonstrated unilateral involvement in 37 patients, bilateral one – in six (6) patients. The change in the shape, height, configuration of femoral or tibial condyles resulted in the knee deformity which was predominantly varus (22) or valgus (19), but the deformity torsion component also took place in the patients, as well as moderately marked antecurvation deformities, however, the deformities in the sagittal plane prevailed. Computed tomography allowed to reveal the significant bone density reduction in the area of metaphysis and epiphysis in all the patients. Cortical density was also reduced in all the patients and amounted to 1014.21±117.03 HU in children at the age of 7-11 years, and 1065.92 HU – in children at the age of 14-18 years being considerably differed from the values of the normal limb. As for adult patients, their density of femoral or tibial meta-epiphyseal part didn’t exceed 108-120 HU with resorption zones of various amount. Specific changes revealed as “starry-shaped” foci of sclerosis.
Conclusion. The results allow to systematize the changes in the knee structures to better extent in order to plan further treatment.