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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Case Report

Emphysematous Osteomyelitis: Novel Use of PET-MRI and a Review of Characteristic Imaging Findings

Author(s): Kush Purohit*, Beiyi Shen, Alvaro Bravo-Martinez, Justin Halterman and Musa Mufti

Volume 19, Issue 10, 2023

Published on: 14 October, 2022

Article ID: e280922209219 Pages: 5

DOI: 10.2174/1573405618666220928090851

Price: $65

Abstract

Introduction: Emphysematous Osteomyelitis (EO) is an extremely rare bone infection caused by gas-forming bacteria with few documented cases in the literature. Our study aims to highlight characteristic imaging features, including the novel use of positron emission tomographymagnetic resonance imaging (PET-MRI) in diagnosing this potentially fatal entity.

Case: Radiography and computed tomography (CT) of the pelvis were performed due to complaints of persistent back pain in a 36-year-old male with a history of recent abdominal aorta surgery. Sacroiliac joint aspiration was performed, and a follow-up PET-MRI was subsequently performed.

Results: Radiography and CT demonstrated bilateral sacroiliitis, osteonecrosis and EO in the bony pelvis. Left sacroiliac joint aspiration identified Staphylococcus aureus as the causative organism. PET-MRI revealed EO with left iliopsoas abscess and abdominal aortic graft infection. The patient's symptoms resolved following antibiotic therapy and image-guided abscess drainage.

Conclusion: EO is a lethal variant of osteomyelitis with a dearth of published cases. Pertinent imaging characteristics of EO on radiography, CT and PET-MRI are discussed here, along with a review of the literature surrounding this rare condition.

Keywords: Emphysematous osteomyelitis, osteomyelitis, bone infection, osteonecrosis, sacroiliitis, PET-MRI

Graphical Abstract

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