title: Interobserver agreement of magnetic resonance imaging signs of osteomyelitis in pelvic pressure ulcers in patients with spinal cord injury.
abstract: OBJECTIVE
  To examine the interobserver reliability of magnetic resonance imaging (MRI) signs of osteomyelitis in complex chronic pressure ulcers in patients with spinal cord injury (SCI).
  
  
  METHODS
  Retrospective review study.
  
  
  METHODS
  Specialist SCI rehabilitation center.
  
  
  METHODS
  Adult patients with SCI and pressure ulceration investigated with MRI.
  
  
  METHODS
  Analysis of MRI examinations and clinical records collected over a 4-year period. Images were independently assessed by 2 experienced radiologists for osteomyelitis based on assigned predictive indicators including cortical bone erosion, soft tissue edema, deep collections, heterotopic new bone, hip effusion, and abnormal signal change of the marrow.
  
  
  METHODS
  Interobserver agreement for indicative MRI signs of osteomyelitis in complex pressure ulcers.
  
  
  RESULTS
  Thirty-seven patients underwent 41 MRI scans. Concordance for marrow edema was 71% on both short tau inversion recovery and T1-weighted sequences, and for cortical erosion was 85%.
  
  
  CONCLUSIONS
  For the assessment of pelvic osteomyelitis related to pressure ulcers, the T1-weighted MRI signal for marrow edema and cortical erosion has strong interobserver agreement.
authors.affiliation: Department of Radiology, John Radcliffe Hospital, Oxford, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hauptfleisch
authors.forename: Tom M
authors.initials: TM
authors.lastname: Meagher
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Hughes
authors.forename: Jay P
authors.initials: JP
authors.lastname: Singh
authors.forename: Allison
authors.initials: A
authors.lastname: Graham
authors.forename: Luis
authors.initials: L
authors.lastname: López de Heredia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis*; D010388:Pelvis; D003668:Pressure Ulcer / Q000175:diagnosis*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*