Optimal imaging strategy for community-acquired Staphylococcus aureus musculoskeletal infections in children

Lorna P. Browne, Edward Mason, Sheldon Kaplan, Christopher I. Cassady, Rajesh Krishnamurthy, R. Paul Guillerman

Research output: Contribution to journalArticlepeer-review

99 Scopus citations


Background: 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. Objective: To appraise the diagnostic efficacy of imaging practices performed for CA-SA osteomyelitis and its complications. Materials and methods: 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. Results: 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). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)841-847
Number of pages7
JournalPediatric Radiology
Issue number8
StatePublished - Aug 1 2008


  • Bone scintigraphy
  • Children
  • Complications
  • MRI
  • Osteomyelitis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health
  • Radiological and Ultrasound Technology


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