Reactivation in post-traumatic chronic osteomyelitis: ultrasonographic findings.
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.
Venkatesh
Sudhakar K
SK
Dept. of Diagnostic Imaging, National University Hospital, Singapore.
Riederer
Barbara
B
Chhem
Rethy K
RK
Cardinal
Etienne
E
Wang
Shih Chang
SC
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