A multifaceted osteomyelitis: radiological diagnosis

Abstract

Introduction Analysis of the literature and our own data confirm that changes in bone structure in chronic osteomyelitis vary in extension and severity, the boundaries of which are very difficult to determine. Purpose To analyze the extension of the lesion and the depth of bone structure destruction with the method of MSCT in various types of osteomyelitis and variants of its location. Materials and methods The study is retrospective and single-center. The method of polypositional radiography and multislice computed tomography (MSCT) was used to study the features of the X-ray morphology of the femur and tibia with a quantitative assessment of the density of various bone areas in 235 patients with chronic osteomyelitis. Results Chronic osteomyelitis was mostly located in the diaphysis of the femur (33) and tibia (52). Osteomyelitis in all cases was post-traumatic or post-surgical. Fourteen patients had pseudarthrosis or bone defect as a result of a long duration of the disease. Analysis of MSCT data showed that anatomical changes in the femur and tibia in chronic osteomyelitis were individual in all patients. Radiographic morphological manifestations consisted of general symptoms (osteoporosis, osteosclerosis, disorders in architectonics). However, the severity, extension and nature of the structural changes were extremely diverse. The change in bone density featured large deviations. Conclusion The data obtained indicate that the “imaging reality” in the diagnosis of chronic osteomyelitis is computed tomography as it enables to determine the extension and nature of bone changes, to detail various changes in anatomy and architectonics, indicating the “multifaceted character” of chronic osteomyelitis.