title: Mandatory bone scans for the assessment of extremity loss in meningococcal septicaemia?
abstract: Meningococcal septicaemia can cause progressive necrosis of skin, soft tissue and bone. Successful limb reconstruction following the disease depends on an accurate assessment of the viability of these tissues and on a multidisciplinary team approach to ensure optimal care. However, bone scanning is not commonly performed in these patients. We present a case of meningococcal septicaemia where bone scanning significantly altered the management by demonstrating an extensive area of bone necrosis proximal to the soft-tissue necrosis. In view of this finding, we propose that bone scanning should be considered in all cases of meningococcal septicaemia where there is tissue necrosis affecting a limb, and that the radiologist should be considered a vital member of the multidisciplinary team.
authors.affiliation: The Odstock Centre for Burns, Plastic and Maxillofacial Surgery, Salisbury District Hospital, Salisbury, UK.
authors.forename: L J
authors.initials: LJ
authors.lastname: Treharne
authors.forename: P
authors.initials: P
authors.lastname: Banwell
authors.forename: M
authors.initials: M
authors.lastname: Cadier
mesh_terms: D000843:Ankle Joint / Q000098:blood supply / Q000000981:diagnostic imaging; D001850:Bone Diseases, Infectious / Q000000981:diagnostic imaging* / Q000382:microbiology; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000473:pathology; D002675:Child, Preschool; D005528:Foot / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging; D008297:Male; D008589:Meningococcal Infections / Q000000981:diagnostic imaging* / Q000473:pathology; D009336:Necrosis; D011877:Radionuclide Imaging; D018805:Sepsis / Q000000981:diagnostic imaging* / Q000473:pathology; D013977:Tibia / Q000098:blood supply / Q000000981:diagnostic imaging