title: Diagnosis of hematogenous pyogenic vertebral osteomyelitis by magnetic resonance imaging.
abstract: The clinical information and imaging data from 27 patients with hematogenous pyogenic vertebral osteomyelitis were reviewed. All patients had roentgenographic and magnetic resonance imaging examinations. Seventeen patients had computed tomograms; 17 had technetium Tc 99m medronate bone scans; and seven had gallium citrate Ga 67 scans. Magnetic resonance imaging, when used as a part of the initial radiologic evaluation, detected abnormalities consistent with osteomyelitis in all 27 patients. Magnetic resonance imaging also demonstrated paravertebral and/or epidural extension of infection in 14 patients, including seven patients who had neurologic signs of lower-extremity weakness. Roentgenograms, computed tomograms, technetium bone scans, and gallium scans had findings suggestive of the diagnosis in 48%, 65%, 71%, and 86% of the patients, respectively. We recommend magnetic resonance imaging as an important and perhaps critical imaging modality for detection of pyogenic vertebral osteomyelitis.
authors.affiliation: Department of Radiology, Mt Sinai Medical Center, Cleveland, Ohio 44106.
authors.forename: S P
authors.initials: SP
authors.lastname: Meyers
authors.forename: S N
authors.initials: SN
authors.lastname: Wiener
mesh_terms: D005069:Evaluation Studies as Topic; D005260:Female; D005710:Gallium Radioisotopes; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis*; D013669:Technetium Tc 99m Medronate; D013904:Thoracic Vertebrae / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D005710:Gallium Radioisotopes; D013669:Technetium Tc 99m Medronate