Osteomiyelit, klinisyenler için sıklıkla tanısal zorluk oluşturan, giderek yaygınlaşan bir hastalıktır. Yaşam veya uzuv kaybına neden olabilecek komplikasyonları önlemek için doğru ve zamanında tanı çok önemlidir. Hikâye, fiziksel muayene ve laboratuvar çalışmalarının yanı sıra, tanısal görüntüleme de tanı sürecinde çok önemlidir. Bu anlatı inceleme makalesinde, osteomiyelit tanısı koymak için kullanılan çeşitli görüntüleme yöntemleri, yani düz radyografi, bilgisayarlı tomografi (BT), manyetik rezonans görüntüleme (MRG), ultrasonografi, kemik sintigrafisi ve pozitron emisyon tomografisi (PET) ele alınmaktadır. PubMed'den makaleler elde edilmiş ve "osteomiyelit için tanısal görüntüleme” konusuyla ilgisi açısından taranmıştır. Yazarlar, görüntüler osteolitik değişiklikleri ortaya çıkarabileceğinden ve alternatif hastalıkları dışlamaya yardımcı olabileceğinden, düz radyografinin uygun bir ilk adım olduğu sonucuna varmıştır. Hassas olması ve kemik iliği değişikliklerini enfeksiyondan sonraki birkaç gün içinde ortaya çıkarabilmesi nedeniyle en uygun ikinci adım genellikle MRG’dir. MRG yapılamayan hastalarda BT, ultrasonografi ve kemik sintigrafisi gibi diğer görüntüleme yöntemleri faydalı olabilir. BT, kronik enfeksiyonlarda nekrotik kemiği tanımlamak için faydalıdır. Ultrasonografi, orak hücre hastalığı olan çocuklarda veya kişilerde faydalı olabilir. Kemik sintigrafisi özellikle vertebral osteomiyelitin saptanmasında faydalıdır. Son olarak, PET yüksek hassasiyet ve özgüllük sergiler, ancak klinik uygulaması, yüksek maliyeti ve yetersiz düzeyde bulunabilir olması nedeniyle sınırlıdır. Uygun kullanıldığında tanısal görüntüleme, osteomiyeliti saptamak için yüksek düzeyde hassas ve spesifik bir yöntem olabilir, bu da onu güçten düşüren bu hastalığın tanı sürecinde çok önemli bir adım haline getirir.
Osteomyelitis
is an increasingly common pathology condition that often poses a diagnostic challenge
to clinicians. Accurate and timely diagnosis is critical to prevent
complications that can result in the loss of life or limb. In addition to
history, physical examexamination, and laboratory studies, diagnostic
imaging plays an essential role in the diagnostic process. This narrative
review article discusses various imaging modalities employed to diagnose osteomyelitis1:, namely plain filmsradiography, computed tomography (CT), magnetic
resonance imaging (MRI), ultrasoundultrasonography2, bone scintigraphy, and positron
emission tomography (PET). Articles were obtained from PubMed and screened for
relevance to the topic of diagnostic imaging for osteomyelitis. The authors concludeconcluded3
that plain films are radiography is an appropriate first step as they because the
images4 may reveal osteolytic changes and can help rule out
alternative pathologydisease. MRI is often the most appropriate second study, asstep because it is highly sensitive and can detectreveal5
bone marrow changes within days of an infection. Other studiesimaging
modalities6 such as CT, ultrasoundultrasonography, and bone scintigraphy may be
useful in patients who cannot undergo MRI. CT is useful for identifying
necrotic bones in chronic infections. UltrasoundUltrasonography may be useful in children or with
sickle-cell disease. Bone scintigraphy is particularly useful for detecting7 vertebral osteomyelitis. Finally, PET
has demonstrated high sensitivity and specificity; however, its clinical
application is limited by its high cost and poor availability. When used
appropriately, diagnostic imaging can providebe highly
sensitiveity
and specificity for detecting osteomyelitis, making radiographic evaluation a
crucial step in the diagnostic process of this debilitating condition.
Osteomyelitis
is an increasingly common pathology condition that often
posespossesses1 a diagnostic
challenge to the clinicians. Accurate
and timely diagnosis is critical to preventcrucial for preventing2 complications that can
result in the loss of life or limb. In addition to history, physical examexamination,
and laboratory studies, diagnostic imaging plays anis3 essential role in
the diagnostic process. This4In this narrative review article discusses,
various imaging modalities employed to diagnose osteomyelitis5:,
namely are described; these include plain filmsradiography, computed tomography (CT), magnetic
resonance imaging (MRI), ultrasoundultrasonography6, bone scintigraphy, and positron
emission tomography (PET). Articles were obtained
from identified through7 PubMed
and screened for relevance to the topic of diagnostic imaging for
osteomyelitis. The authors concludeconcluded8 that plain films
are radiography is an
appropriate first step as they because the images9 may reveal osteolytic changes
and can help rule out alternative pathologydisease. MRI is often the most appropriate second study, asstep because it is highly sensitive and can detectreveal10
bone marrow changes within days of an infection. Other studiesimaging
modalities11 such as CT, ultrasoundultrasonography, and bone scintigraphy may be
useful infor
patients in who MRI cannot undergo
MRIbe performed. CT is useful
for identifying necrotic bones in chronic infections. UltrasoundUltrasonography
may be useful in children or individuals
with sickle-cell disease. Bone scintigraphy is particularly useful forin12 detecting13 vertebral osteomyelitis. Finally, PET
has demonstrated high sensitivity and specificity; however, as it is expensive and often unavailable its
clinical application is limited by its high cost and
poor availability. When used appropriately, diagnostic imaging can providebe highly
sensitiveity and specificity for detecting osteomyelitis, making radiographic
evaluation has high sensitivity and specificity for
detecting osteomyelitis; thus, it is a crucial step in the diagnostic process ofdiagnosing this debilitating condition.
Osteomyelitis is an increasingly common condition that possesses a diagnostic challenge to the clinicians. Accurate and timely diagnosis is crucial for preventing complications that can result in the loss of life or limb. In addition to history, physical examination, and laboratory studies, diagnostic imaging is essential in the diagnostic process. In this narrative review article, various imaging modalities to diagnose osteomyelitis are described; these includeplain radiography, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, bone scintigraphy, and positron emission tomography (PET). Articles were identified through PubMed and screened for relevance to the topic of diagnostic imaging for osteomyelitis. The authors concluded that plain radiography is an appropriate first step because the images may reveal osteolytic changes and can help rule out alternative disease. MRI is often the most appropriate second step because it is highly sensitive and can reveal bone marrow changes within days of an infection. Other imaging modalities such as CT, ultrasonography, and bone scintigraphy may be useful for patients in who MRI cannot be performed. CT is useful for identifying necrotic bone in chronic infections. Ultrasonography may be useful in children or individuals with sickle-cell disease. Bone scintigraphy is particularly useful in detecting vertebral osteomyelitis. Finally, PET has demonstrated high sensitivity and specificity; however, as it is expensive and often unavailable its clinical application is limited. When used appropriately, radiographic evaluation has high sensitivity and specificity for detecting osteomyelitis; thus, it is a crucial step in diagnosing this debilitating condition.