Emphysematous Osteomyelitis: Novel Use of PET-MRI and a Review of
Characteristic Imaging Findings
-
Published:2023-09
Issue:10
Volume:19
Page:1214-1218
-
ISSN:1573-4056
-
Container-title:Current Medical Imaging Formerly Current Medical Imaging Reviews
-
language:en
-
Short-container-title:CMIR
Author:
Purohit Kush1ORCID,
Shen Beiyi1,
Bravo-Martinez Alvaro1,
Halterman Justin1,
Mufti Musa1
Affiliation:
1. Department of Radiology, SUNY at Stony Brook University School of Medicine, 101 Nicolls Rd, Stony Brook, New
York 11794, USA
Abstract
Introduction:
Emphysematous osteomyelitis (EO) is an extremely rare bone infection by gas-forming bacteria with few documented cases in the literature. Our study aims to highlight characteristic imaging features, including the novel use of positron emission tomography-magnetic resonance imaging (PET-MRI) in the diagnosis of this potentially fatal entity.
Case:
Radiography and computed tomography (CT) of the pelvis were performed due to complaints of persistent back pain in a 36 year old male with history of recent abdominal aorta surgery. Sacroiliac joint aspiration was performed and a follow-up PET-MRI was subsequently performed.
Results: Radiography and CT demonstrated bilateral sacroiliitis, osteonecrosis and EO in the bony pelvis. Left sacroiliac joint aspiration identified Staphylococcus aureus as the causative organism. PET-MRI revealed EO with left iliopsoas abscess and abdominal aortic graft infection. The patient's symptoms resolved following antibiotic therapy and image-guided abscess drainage.
Conclusion:
EO is a lethal variant of osteomyelitis with a dearth of published cases. Pertinent imaging characteristics of EO on radiography, CT and PET-MRI are discussed here, along with a review of the literature surrounding this rare condition.
Publisher
Bentham Science Publishers Ltd.
Subject
Radiology, Nuclear Medicine and imaging