Abstract
Non-invasive diagnostic methods in chronic bone infection serve to confirm the suspicion of osteomyelitis, determine the extent and localisation of infection with bone marrow involvement, delineate small sequestra, intraosseous fistula and abscesses, as well as determine bone instabilities, material failure or infection. Projection radiography, computed tomography (CT), magnetic resonance imagining (MRI), skeletal and inflammatory lesion scintigraphy, as well as positron emission tomography (PET) are established methods. Osteosynthesis material can only be identified on radiography (projection radiography, CT), while infection sites and extent are better appreciated with functionally oriented methods (MRI, scintigraphy, PET). Thus, a combination of various methods is essential. Conventional X-ray provides a prompt initial overview. In the case of foreign bodies being identified, PET/CT with fluorodeoxyglucose (FDG) is indicated for further clarification; in the case of absent material, either MRI or PET/CT are indicated. The latter both provide a reliable assessment of the extent and localisation of bone infection and are able to determine peripheral and soft tissue infections, as well as providing a differential diagnostic cut-off point in terms of neoplasms.
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