Imaging of musculoskeletal infections

Christopher J. Palestro, Charito Love, Theodore T. Miller

Research output: Contribution to journalReview articlepeer-review

129 Scopus citations


Imaging procedures are routinely used to evaluate patients suspected of having musculoskeletal infection. Radiographs should be performed whenever musculoskeletal infection is suspected. Even when not diagnostic, radiographs are useful. They provide an anatomic overview of the region of interest, including pre-existing conditions that could influence the selection and interpretation of subsequent procedures. Magnetic resonance imaging (MRI) is sensitive, provides superb anatomic detail, does not use ionizing radiation, and is rapidly completed. This technique is especially valuable for septic arthritis, spinal osteomyelitis, and diabetic foot infections. Among the radionuclide procedures, three-phase bone imaging is readily available, and very accurate in unviolated bone. Labeled leukocyte imaging should be used in cases of 'complicating osteomyelitis' such as prosthetic joint infections. This test is also useful in unsuspected diabetic pedal osteomyelitis and the neuropathic joint. Gallium imaging is a useful adjunct to MIR in spinal infection. 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) will likely play an important role, especially in the evaluation of spinal infection.

Original languageEnglish (US)
Pages (from-to)1197-1218
Number of pages22
JournalBest Practice and Research: Clinical Rheumatology
Issue number6
StatePublished - Dec 2006
Externally publishedYes


  • bone scintigraphy
  • computed tomography
  • gallium
  • labeled leukocytes
  • magnetic resonance imaging
  • musculoskeletal infection
  • osteomyelitis
  • radiographs
  • ultrasonography

ASJC Scopus subject areas

  • Rheumatology


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