An imaging approach to musculoskeletal infections

Imaging techniques can provide useful information and also guidance for diagnostic aspirations of joints and disk spaces. This paper provides a suggested approach to the diagnosis of osteomyelitis. Isotope studies and magnetic resonance images will usually be positive before conventional radiographs. Tomography, In-111 white blood cell scans, and Ga-67 scans are useful in detecting activity in chronic or subacute cases. Since the diagnostic approach to evaluation of joint space disease depends upon the presence or absence of surgical appliances (joint replacements) isotope studies and arthrography are most accurate in this setting. Finally, computed tomography provides the most anatomic detail in study of disk space infection and also provides an excellent approach for aspiration