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- Title
Performance of a rapid two-sequence screening protocol for osteomyelitis of the foot.
- Authors
Singer, Adam D.; Umpierrez, Monica; Kakarala, Aparna; Schechter, Marcos C.; Maceroli, Michael; Sharma, Gulshan B.; Rajani, Ravi R.
- Abstract
<bold>Objective: </bold>Compare a two sequence protocol to a standard protocol in the detection of pedal osteomyelitis (OM) and abscesses and to identify patients that benefit from a full protocol.<bold>Materials and Methods: </bold>One hundred thirty-two foot MRIs ordered to assess for OM were enrolled, and the following items were extracted from the clinical reports: use of IV contrast, the presence of OM, reactive osteitis, and a soft tissue abscess. Using only one T1 nonfat-suppressed and one fluid sensitive fat-suppressed sequences, two experienced musculoskeletal radiologists reviewed each case for the presence of OM, reactive osteitis, or an abscess. A Kappa test was calculated to assess for interobserver agreement, and diagnostic performance was determined. The McNemar test was used to assess for the effect of contrast.<bold>Results: </bold>Agreement between both observers and the clinical report on the presence of osteomyelitis was substantial ( k = 0.63 and 0.72, p < 0.001), while the agreement for abscess was fair (k = 0.29 and 0.38, p < 0.001). For osteomyelitis, both observers showed good accuracy (0.85 and 0.86). When screening bone for a normal versus abnormal case, this method was highly sensitive (0.97-0.98), but was less sensitive for abscess (0.63-0.75). Fifty-one percent of exams used contrast, and it did impact the diagnosis of abscess for one observer.<bold>Conclusion: </bold>This rapid protocol is accurate in making the diagnosis of OM, and its high sensitivity makes it useful to screen for patients that would benefit from a full protocol.
- Subjects
OSTEITIS; FOOT; BONES; OSTEOMYELITIS; CONTRAST effect; ABSCESSES
- Publication
Skeletal Radiology, 2020, Vol 49, Issue 6, p977
- ISSN
0364-2348
- Publication type
journal article
- DOI
10.1007/s00256-019-03367-x