| Title | Optimal imaging strategy for community-acquired Staphylococcus aureus musculoskeletal infections in children. | | Author(s) | Browne LP, Mason EO, Kaplan SL, Cassady CI, Krishnamurthy R, Guillerman RP | | Institution | Edward B. Singleton Department of Diagnostic Imaging, Texas Children’s Hospital, MC-2251, 6621 Fannin St., Houston, TX, 77030, USA, lxbrowne@texaschildrenshospital.org. | | Source | Pediatr Radiol 2008 Jun 17. | | Abstract | BACKGROUND: Invasive musculoskeletal infections from community-acquired methicillin-resistant and methicillin-susceptible Staphylococcus aureus (CA-SA) are increasingly encountered in children. Imaging is frequently requested in these children for diagnosis and planning of therapeutic interventions.
OBJECTIVE: To appraise the diagnostic efficacy of imaging practices performed for CA-SA osteomyelitis and its complications.
MATERIALS AND METHODS: A retrospective review was conducted of the clinical charts and imaging studies of CA-SA osteomyelitis cases since 2001 at a large children's hospital.
RESULTS: Of 199 children diagnosed with CA-SA osteomyelitis, 160 underwent MRI examination and 35 underwent bone scintigraphy. The sensitivity of MRI and bone scintigraphy for CA-SA osteomyelitis was 98% and 53%, respectively. In all discordant cases, MRI was correct compared to bone scintigraphy. Extraosseous complications of CA-SA osteomyelitis detected only by MRI included subperiosteal abscesses (n = 77), pyomyositis (n = 43), septic arthritis (n = 31), and deep venous thrombosis (n = 12).
CONCLUSION: MRI is the preferred imaging modality for the investigation of pediatric CA-SA musculoskeletal infection because it offers superior sensitivity for osteomyelitis compared to bone scintigraphy and detects extraosseous complications that occur in a substantial proportion of patients. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 18560822 |
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