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- Title
Optimal imaging strategy for community-acquired Staphylococcus aureus musculoskeletal infections in children.
- Authors
Browne, Lorna P.; Mason, Edward O.; Kaplan, Sheldon L.; Cassady, Christopher I.; Krishnamurthy, Rajesh; Guillerman, R. Paul
- Abstract
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. To appraise the diagnostic efficacy of imaging practices performed for CA-SA osteomyelitis and its complications. 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. 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). 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.
- Subjects
STAPHYLOCOCCUS aureus infections; DIAGNOSIS of musculoskeletal system diseases; OSTEOMYELITIS diagnosis; PEDIATRIC diagnosis; DISEASE complications; IMAGING systems; THERAPEUTICS; DIAGNOSIS
- Publication
Pediatric Radiology, 2008, Vol 38, Issue 8, p841
- ISSN
0301-0449
- Publication type
Article
- DOI
10.1007/s00247-008-0888-8