Magnetic resonance imaging in the diagnosis of acute hematogenous osteomyelitis in children

Abstract

Aim of the study: to show the possibilities of magnetic resonance imaging for the diagnosis of acute osteomyelitis. Materials and methods. One hundred thirty two children with hematogenous osteomyelitis (n = 112 - 84.8%), including BCG-osteomyelitis (n = 20 - 15.2%), aged 1 to 17 years, average age - 9.1 ± 4.9 years, were examined between 2011 and 2020. Out of 132 children, 77 were operated on (58.3%). Boys predominated - 70 (53%) patients, girls - 62 (47%). MRI was performed on a Philips Achieva dStream 3.0 T. Results. Over the first three days after onset of the disease, when radiography and CT did not reveal bone pathological changes, according to MRI acute osteomyelitis was detected in all patients (n = 51). The topical location of osteomyelitis foci was clearly established. Discussion. MRI is the most informative method for visualizing acute hematogenous osteomyelitis over first days of the disease. MRI clearly shows initial bone remodelling and bone marrow edema, including the such earliest sign as perifocal myositis. The most effective MRI sequences are STIR and T2WI, regardless of the pulse sequence, in which a pronounced hyperintense signal is visualized. Whole body MRI combined with clinical data is considered a promising method for distinguishing inflammatory processes from other specific diseases.