Comparative analysis of the results of multispiral computed tomography using color mapping and magnetic resonance imaging in the diagnosis of acute hematogenous osteomyelitis in children

Abstract

BACKGROUND: Although acute hematogenous osteomyelitis is considered a fairly well-studied disease, several articles emphasize that the frequency of diagnostic errors remains quite high. The clinical presentation of acute hematogenous osteomyelitis largely depends on its reactivity and localization. The latter has features of the clinical course in children of different age groups. Osteomyelitis can be difficult to detect because of the variability and nonspecificity of symptoms and physical and laboratory parameters. Rapid diagnosis is crucial for successful disease outcomes because untimely treatment increases the number of complications. Therefore, visualization should be aimed at early diagnosis and, ultimately, successful treatment.

AIM: This study aimed to evaluate the informative value of magnetic resonance imaging and multispiral computed tomography (MSCT) in the diagnosis of the intramedullary phase of acute hematogenous osteomyelitis as its earliest stage.

MATERIALS AND METHODS: Thirty patients suspected with acute hematogenous osteomyelitis underwent magnetic resonance imaging and MSCT using color mapping techniques and X-ray density assessment. At the final stage of the diagnostic algorithm, osteotonometry was performed. The contents of the bone marrow canal were taken for microbiological and bacteriological studies.

RESULTS: In the intramedullary phase of acute hematogenous osteomyelitis, magnetic resonance imaging and MSCT revealed signs of bone marrow edema in 96% of the cases. The sensitivity of magnetic resonance imaging was 96%, the same as that of MSCT; however, the specificity was significantly lower than that of MSCT using the color mapping method and X-ray density assessment, which was 67% and 83%, respectively (p < 0.05).

DISCUSSION: In recent years, the role of computed tomography in the diagnosis of acute hematogenous osteomyelitis has received considerable recognition in pediatric surgical practice, and MSCT with color mapping and X-ray density assessment in the diagnosis of acute hematogenous osteomyelitis in children has been used relatively recently. Simultaneously, many researchers have reported the high informativeness of MSCT in the diagnosis of acute hematogenous osteomyelitis.

CONCLUSIONS: The intramedullary phase of acute hematogenous osteomyelitis according to magnetic resonance imaging and MSCT indicates bone marrow edema as its earliest stage. According to the data of the present study, MSCT using color mapping and X-ray density assessment has high specificity and can be used with MRI as the main method for diagnosing the intramedullary phase of acute hematogenous osteomyelitis.

Keywords

multispiral computed tomography / magnetic resonance imaging / acute hematogenous osteomyelitis / intramedullary phase / diagnostics / children

References

[1] Shamsiev ZhA, Shamsiev AM, Makhmudov ZM. To the question of early diagnosis of acute hematogenous osteomyelitis of bones of the hip joint in children. Pediatric surgery. 2018;22(2):83–88.

[2] Шамсиев Ж.А., Шамсиев А.М., Махмудов З.М. К вопросу ранней диагностики острого гематогенного остеомиелита костей тазобедренного сустава у детей // Детская хирургия. 2018. Т. 22, № 2. С. 83–88.

[3] Shamsiev ZhA, Shamsiev AM, Makhmudov ZM. To the question of early diagnosis of acute hematogenous osteomyelitis of bones of the hip joint in children. Pediatric surgery. 2018;22(2):83–88.

[4] Sazhin AA, Rumyantseva GN. Features of the course of metaepiphyseal osteomyelitis in young children. Tver Medical Journal. 2017;(3):70–72. (In Russ.)

[5] Сажин А.А., Румянцева Г.Н. Особенности течения метаэпифизарного остеомиелита у детей раннего возраста // Тверской медицинский журнал. 2017. № 3. С. 70–72.

[6] Sazhin AA, Rumyantseva GN. Features of the course of metaepiphyseal osteomyelitis in young children. Tver Medical Journal. 2017;(3):70–72. (In Russ.)

[7] Lyurov DA, Svarich VG, Рozdnjakov AV. Optimization techniques for early diagnosis of acute gematogennogo osteomyelitis in children. Visualization in medicine. 2020;2(3):13–21.

[8] Лыюров Д.А., Сварич В.Г., Поздняков А.В. Оптимизация методики ранней диагностики острого гематогенного остеомиелита у детей // Визуализация в медицине. 2020. Т. 2, № 3. С. 13–21.

[9] Lyurov DA, Svarich VG, Рozdnjakov AV. Optimization techniques for early diagnosis of acute gematogennogo osteomyelitis in children. Visualization in medicine. 2020;2(3):13–21.

[10] Mamatov AM, Abhadylykov ZA, Kamshibekov UA, Boronbaeva EA. Treatment of septic forms of acute osteomyelitis in children. Bulletin of Science and Practice. 2018;4(11):97–100. DOI: 10.5281/zenodo.1488116

[11] Маматов А.М., Абдыхаликов Ж.А., Камчыбеков У.А., Боронбаева Э.А. Лечение септических форм острого гематогенного остеомиелита у детей // Бюллетень науки и практики. 2018. Т. 4, № 11. С. 97–100. DOI: 10.5281/zenodo.1488116

[12] Mamatov AM, Abhadylykov ZA, Kamshibekov UA, Boronbaeva EA. Treatment of septic forms of acute osteomyelitis in children. Bulletin of Science and Practice. 2018;4(11):97–100. DOI: 10.5281/zenodo.1488116

[13] Rumyantseva GN, Gorshkov AY, Sergeechev SP, Mikhailova SI. Acute metaepiphyseal osteomyelitis in young children, peculiarities of course and diagnosis. Modern problems of science and education. 2017;(4):41.

[14] Румянцева Г.Н., Горшков А.Ю., Сергеечев С.П., Михайлова С.И. Острый метаэпифизарный остеомиелит у детей раннего возраста, особенности течения и диагностики // Современные проблемы науки и образования. 2017. № 4. С. 41.

[15] Rumyantseva GN, Gorshkov AY, Sergeechev SP, Mikhailova SI. Acute metaepiphyseal osteomyelitis in young children, peculiarities of course and diagnosis. Modern problems of science and education. 2017;(4):41.

[16] Arnold JC, Bradley JC. Osteoarticular infections in children. Infect Dis Clin North Am. 2015;29(3):557–574. DOI: 10.1016/j.idc.2015.05.012

[17] Arnold J.C., Bradley J.C. Osteoarticular infections in children // Infect Dis Clin North Am. 2015. Vol. 29, No. 3. P. 557–574. DOI: 10.1016/j.idc.2015.05.012

[18] Arnold JC, Bradley JC. Osteoarticular infections in children. Infect Dis Clin North Am. 2015;29(3):557–574. DOI: 10.1016/j.idc.2015.05.012

[19] Eshonova TD. Acute hematogenous osteomyelitis in children. Pediatria n.a. after G.N. Speransky. 2016;95(2):146–152.

[20] Эшонова Т.Д. Острый гематогенный остеомиелит у детей // Педиатрия. Журнал им. Г.Н. Сперанского. 2016. Т. 95, № 2. С. 146–152.

[21] Eshonova TD. Acute hematogenous osteomyelitis in children. Pediatria n.a. after G.N. Speransky. 2016;95(2):146–152.

[22] Karmazanovsky GG. Assessment of diagnostic significance of the method (sensitivity, specificity, overall accuracy). Annals of HPB Surgery. 1997;2:139–142.

[23] Кармазановский Г.Г. Оценка диагностической значимости метода (чувствительность, специфичность, общая точность.) // Анналы хирургической гепатологии. 1997. Т. 2. С. 139–142.

[24] Karmazanovsky GG. Assessment of diagnostic significance of the method (sensitivity, specificity, overall accuracy). Annals of HPB Surgery. 1997;2:139–142.

[25] Rumyantseva GN, Gorshkov AY, Sergeechev SP, Mikhailova SI. Methods of radial diagnostics in acute metaepiphyseal osteomyelitis. Pediatric surgery. 2019;23(1S3):56. (In Russ.)

[26] Румянцева Г.Н., Горшков А.Ю., Сергеечев С.П., Михайлова С.И. Методы лучевой диагностики при остром метаэпифизарном остеомиелите // Детская хирургия. 2019. Т. 23, № 1S3. С. 56.

[27] Rumyantseva GN, Gorshkov AY, Sergeechev SP, Mikhailova SI. Methods of radial diagnostics in acute metaepiphyseal osteomyelitis. Pediatric surgery. 2019;23(1S3):56. (In Russ.)

[28] Minaev SV, Filipieva NV, Leskin VV, et al. Radiological methods in diagnostics of acute haematogenous osteomyelitis in children. Doctor.Ru. 2018;(5):32–36. DOI: 10.31550/1727-2378-2018-149-5-32-36

[29] Минаев С.В., Филипьева Н.В., Лескин В.В., и др. Применение лучевых методов в диагностике острого гематогенного остеомиелита у детей // Доктор.Ру. 2018. № 5. С. 32–36. DOI: 10.31550/1727-2378-2018-149-5-32-36

[30] Minaev SV, Filipieva NV, Leskin VV, et al. Radiological methods in diagnostics of acute haematogenous osteomyelitis in children. Doctor.Ru. 2018;(5):32–36. DOI: 10.31550/1727-2378-2018-149-5-32-36

[31] Simpfendorfer CS. Radiologic approach to musculoskeletal infections. Infect Dis Clin North Am. 2017;31(2):299–324. DOI: 10.1016/j.idc.2017.01.004

[32] Simpfendorfer C.S. Radiologic approach to musculoskeletal infections // Infect Dis Clin North Am. 2017. Vol. 31, No. 2. P. 299–324. DOI: 10.1016/j.idc.2017.01.004

[33] Simpfendorfer CS. Radiologic approach to musculoskeletal infections. Infect Dis Clin North Am. 2017;31(2):299–324. DOI: 10.1016/j.idc.2017.01.004

[34] James DC, Gail JH, Sheldon LK, et al. Feigin and Cherry’s textbook of pediatric infectious diseases. 7th edition. Elsiver, 2014. Vol. 55. Р. 711–727.

[35] James D.C., Gail J.H., Sheldon L.K., et al. Feigin and Cherry’s textbook of pediatric infectious diseases. 7th edition. Elsiver, 2014. Vol. 55. Р. 711–727.

[36] James DC, Gail JH, Sheldon LK, et al. Feigin and Cherry’s textbook of pediatric infectious diseases. 7th edition. Elsiver, 2014. Vol. 55. Р. 711–727.

[37] Pugmire BS, Shailam R, Gee MS. Role of MRI in the diagnosis and treatment of osteomyelitis in pediatric patients. World J Radiol. 2014;6(8):530–537. DOI: 10.4329/wjr.v6.i8.530

[38] Pugmire B.S., Shailam R., Gee M.S. Role of MRI in the diagnosis and treatment of osteomyelitis in pediatric patients // World J Radiol. 2014. Vol. 6, No. 8. P. 530–537. DOI: 10.4329/wjr.v6.i8.530

[39] Pugmire BS, Shailam R, Gee MS. Role of MRI in the diagnosis and treatment of osteomyelitis in pediatric patients. World J Radiol. 2014;6(8):530–537. DOI: 10.4329/wjr.v6.i8.530

[40] Lee YJ, Sadigh S, Mankad K, et al. The imaging of osteomyelitis. Quant Imaging Med Surg. 2016;6(2):184–198. DOI: 10.21037/qims.2016.04.01

[41] Lee Y.J., Sadigh S., Mankad K., et al. The imaging of osteomyelitis // Quant Imaging Med Surg. 2016. Vol. 6, No. 2. P. 184–198. DOI: 10.21037/qims.2016.04.01

[42] Lee YJ, Sadigh S, Mankad K, et al. The imaging of osteomyelitis. Quant Imaging Med Surg. 2016;6(2):184–198. DOI: 10.21037/qims.2016.04.01

[43] Dartnell J, Ramachandran M, Katchburian M. Haematogenuos acute and subacute paediatric osteomyelitis. A systematic review of the literature. J Bone Joint Surg. 2012;94-B(5):584–595. DOI: 10.1302/0301-620X.94B5.28523

[44] Dartnell J., Ramachandran M., Katchburian M. Haematogenuos acute and subacute paediatric osteomyelitis. A systematic review of the literature // J Bone Joint Surg. 2012. Vol. 94-B, No. 5. P. 584–595. DOI: 10.1302/0301-620X.94B5.28523

[45] Dartnell J, Ramachandran M, Katchburian M. Haematogenuos acute and subacute paediatric osteomyelitis. A systematic review of the literature. J Bone Joint Surg. 2012;94-B(5):584–595. DOI: 10.1302/0301-620X.94B5.28523

[46] Mikhailova SI, Rumyantseva GN, Yusufov AA, et al. Methods of radiation diagnostics of acute hematogenous osteomyelitis in children of different age groups. Modern problems of science and education. 2020;(2):148. DOI: 10.17513/spno.29711

[47] Михайлова С.И., Румянцева Г.Н., Юсуфов А.А., и др. Методы лучевой диагностики острого гематогенного остеомиелита у детей разных возрастных групп // Современные проблемы науки и образования. 2020. № 2. С. 148. DOI: 10.17513/spno.29711

[48] Mikhailova SI, Rumyantseva GN, Yusufov AA, et al. Methods of radiation diagnostics of acute hematogenous osteomyelitis in children of different age groups. Modern problems of science and education. 2020;(2):148. DOI: 10.17513/spno.29711

[49] Strelkov NS, Razin MF. Hematogenic osteomyelitis in children. Moscow: GEOTAR-Media., 2018. 160 p. (In Russ.)

[50] Стрелков Н.С., Разин М.П. Гематогенный остеомиелит у детей. Москва: ГЭОТАР-Медиа, 2018. 160 с.

[51] Strelkov NS, Razin MF. Hematogenic osteomyelitis in children. Moscow: GEOTAR-Media., 2018. 160 p. (In Russ.)

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