MR imaging in the investigation of osteomyelitis in the pediatric extremities

This paper reports six patients (age range, 11 months - 17 years) with metaphyseal osteomyelitis imaged at 1.5 T with conventional MR pulse sequences. In three patients, Gd-DTPA was administered and imaging was done with fat-suppression techniques. Reasons for referral included clarification of bone involvement underlying diffuse abnormality on scintigraphy; investigation of two bone lesions in a single region; normal radiograph and suspected bone sepsis; investigation of a nonspecific bone lesion, and follow-up of sequelae of bilateral femoral osteomyelitis. Enhancement with Gd-DTPA revealed abnormalities not seen on other sequences in two patients. Soft-tissue abnormality was well shown on lipid-suppression images. Abnormal signal extending through the physis into the epiphysis was seen in three patients