title: Reactivation in post-traumatic chronic osteomyelitis: ultrasonographic findings.
abstract: OBJECTIVE
  To describe the ultrasound (US) features of reactivation in post-traumatic chronic osteomyelitis in adults.
  
  
  METHODS
  Twelve patients with clinical suspicion of reactivation of chronic osteomyelitis, secondary to trauma, surgery, and who were investigated with US were selected for the study. The following US features were assessed: periosseous fluid collection, bone changes (periosteal reactions, cortical irregularity, callus, sequestrum and cloaca) and soft-tissue changes (cellulitis and sinus tracts). US findings were correlated with plain radiography (n = 11), computed tomography (n = 3) and magnetic resonance imaging (n = 2).
  
  
  RESULTS
  US detected fluid collections in all patients (12 periosseous and 3 in soft tissues), bone changes in 10 and sinus tracts and cellulitis in 5 patients each. Bone changes detected were cortical irregularity (n = 10), discontinuity of cortex (n = 7), sequestrum (n = 2), callus (n = 2), periosteal reaction (n = 1) and cloaca (n = 1). Cellulitis was seen in 5 patients and sinus tracts in 5. Reactivation was confirmed at surgery in all patients.
  
  
  CONCLUSIONS
  US is a reliable noninvasive imaging modality for the diagnosis of reactivation of post-traumatic chronic osteomyelitis in adults.
authors.affiliation: Dept. of Diagnostic Imaging, National University Hospital, Singapore.
authors.forename: Sudhakar K
authors.initials: SK
authors.lastname: Venkatesh
authors.forename: Barbara
authors.initials: B
authors.lastname: Riederer
authors.forename: Rethy K
authors.initials: RK
authors.lastname: Chhem
authors.forename: Etienne
authors.initials: E
authors.lastname: Cardinal
authors.forename: Shih Chang
authors.initials: SC
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002908:Chronic Disease; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000209:etiology; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000000981:diagnostic imaging; D014463:Ultrasonography