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Eur Radiol. 2017 Jan;27(1):414-423. Epub 2016 May 10.

Role of Diffusion Weighted Imaging in Musculoskeletal Infections: Current Perspectives.

Author information

1
Department of Radiology, Yale New Haven Health System at Bridgeport Hospital, Bridgeport, CT, USA.
2
Department of Orthopaedic Surgery, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA.
3
Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
4
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
5
Department of Orthopaedic Surgery, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA. avneesh.chhabra@utsouthwestern.edu.
6
Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA. avneesh.chhabra@utsouthwestern.edu.

Abstract

Accurate diagnosis and prompt therapy of musculoskeletal infections are important prognostic factors. In most cases, clinical history, examination and laboratory findings help one make the diagnosis, and routine magnetic resonance imaging (MRI) is useful to identify the extent of the disease process. However, in many situations, a routine MRI may not be specific enough especially if the patient cannot receive contrast intravenously, thereby delaying the appropriate treatment. Diffusion-weighted imaging (DWI) can help in many such situations by providing additional information, accurate characterization and defining the extent of the disease, so that prompt treatment can be initiated. In this article, we illustrate the imaging findings of the spectrum of musculoskeletal infections, emphasizing the role of DWI in this domain.

KEY POINTS:

• Abscess in background cellulitis is detected on DWI. • Infectious tenosynovitis shows diffusion restriction as compared to mechanical tenosynovitis. • Pyomyositis with abscess can be differentiated from diabetic myonecrosis on DWI. • Intraosseous abscess is bright on DWI versus devitalized tissue, sequestrum and air. • DWI can be used to differentiate spine infection from simple Modic changes.

KEYWORDS:

Abscess; DWI; Diffusion; Infection; MRI

PMID:
27165135
DOI:
10.1007/s00330-016-4372-9
[Indexed for MEDLINE]
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