Osteomyelitis (Greater Than 18 Months)

  • Etiology: most commonly Staphlococcus aureus, salmonella in sickle cell disease
  • Imaging: primary site is metaphysis + does not involve epiphysis, continuous periosteal reaction, deep soft tissue edema, lack of extra osseous soft tissue mass
  • Complications: subperiosteal abscess, intramedullary abscess, sequestrum (dead bone) resides inside involucrum (periosteal new bone) + debris + pus drains through the cloaca to a fistula / sinus tract to soft tissue + skin
  • Clinical: multicentric in 10%

Cases of Osteomyelitis (Greater Than 18 Months)

Radiograph of chronic osteomyelitis of the femur
AP radiograph of the proximal left femur shows a lucent lesion containing multiple septations that is associated with extensive cortical thickening and periosteal reaction. Percutaneous bone biopsy was performed.
Radiograph and nuclear medicine bone scan of osteomyelitis of the femur
AP radiograph of the pelvis was unremarkable. Nuclear medicine bone scan shows increased radiotracer uptake in the left femoral head and neck and proximal femur.