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

doi:10.1007/s00247-008-0888-8

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 Institute

Research output: Contribution to journal › Article

76 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	841-847
Number of pages	7
Journal	Pediatric Radiology
Volume	38
Issue number	8
DOIs	https://doi.org/10.1007/s00247-008-0888-8
State	Published - Aug 1 2008

Keywords

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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title = "Optimal imaging strategy for community-acquired Staphylococcus aureus musculoskeletal infections in children",

abstract = "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.",

keywords = "Bone scintigraphy, Children, Complications, MRI, Osteomyelitis",

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AU - Krishnamurthy, Rajesh

AU - Guillerman, R. Paul

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N2 - 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.

AB - 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.

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