Osteomyelitis CT

A CT scan can demonstrate osseous and soft-tissue abnormalities, and it is ideal for detecting gas in soft tissues. Bones such as the sternum, vertebrae, pelvic bones, and calcaneus are far better imaged with a CT scan than with plain radiographs.

CT scan is usually more readily available for establishing the diagnosis especially in emergency situations.^[1] In selected children who cannot remain still or tolerate sedation, CT is a valuable imaging modality. CT scan findings may include the following:

• Overlying soft-tissue swelling, periosteal reaction, medullary low-attenuation areas or trabecular coarsening, and focal cortical erosions.
  
• Osseous and soft-tissue abnormalities, and it is ideal for detecting gas in soft tissues.
  Bones such as the sternum, vertebrae, pelvic bones, and calcaneus are far better imaged with a CT scan than with plain radiographs.
  
• CT is most commonly used to detect and to define areas of possible infection in bones with complex anatomy that is difficult to visualize on plain radiographs and bone scans.^[2]
  

The following imaging series demonstrate little infectious nidus of the left femoral neck, synovitis, soft tissue mass (abscess), sequestrum and periosteal reaction in a 4 years old boy with acute hematogenous osteomyelitis of the left femur.