DOI QR코드

DOI QR Code

Lesions that Mimic Musculoskeletal Infection: A Pictorial Essay

근골격계 감염과 유사한 질환들: 임상 화보

  • Kang, Hye Jin (Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University) ;
  • Choi, Hee Young (Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University) ;
  • Park, Ji Seon (Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University) ;
  • Park, So Young (Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University) ;
  • Jin, Wook (Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University) ;
  • Ryu, Kyung Nam (Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University)
  • 강혜진 (경희대학교 의과대학 경희대학교병원 영상의학과) ;
  • 최희영 (경희대학교 의과대학 경희대학교병원 영상의학과) ;
  • 박지선 (경희대학교 의과대학 경희대학교병원 영상의학과) ;
  • 박소영 (경희대학교 의과대학 강동경희대학교병원 영상의학과) ;
  • 진욱 (경희대학교 의과대학 강동경희대학교병원 영상의학과) ;
  • 류경남 (경희대학교 의과대학 경희대학교병원 영상의학과)
  • Received : 2017.08.14
  • Accepted : 2017.11.11
  • Published : 2018.03.01

Abstract

Musculoskeletal (MSK) infections, such as osteomyelitis, infectious arthritis and spondylitis have variable radiographic findings depending on their underlying cause and clinical infection stage. Other disease entities, ranging from simple degenerative lesions to tumorous bone conditions, in which there is no evidence of infectious origin, can share similar radiographic findings. It is important to be aware, when interpreting radiographic features that are typically associated with MSK infections, that a non-infectious MSK disease may be mimicking the radiographic findings of infectious diseases.

골수염, 감염성 관절염 및 척추염과 같은 근골격계 감염은 발생 원인 및 임상 감염 단계에 따라 다양한 영상의학적 소견을 보인다. 그러나 근골격계 감염과 유사한 영상 소견을 보이지만 감염의 증거가 없는 다른 질환들도 존재하며, 이들은 단순 퇴행성 병변에서부터 골 종양에 이르기까지 다양하다. 따라서 근골격계 감염성 질환에서 전형적으로 나타나는 영상의학적 특징들을 접하였을 때 근골격계 감염과 유사한 비감염성 근골격계 질환의 가능성도 함께 고려하는 것이 중요하다.

Keywords

References

  1. Poultsides LA, Liaropoulos LL, Malizos KN. The socioeconomic impact of musculoskeletal infections. J Bone Joint Surg Am 2010;92:e13
  2. Manaster BJ. Diagnostic imaging: musculoskeletal nontraumatic disease. Philadelphia, PA: Elsevier Health Sciences 2016
  3. Resnick D. Osteomyelitis, septic arthritis, and soft tissue infection: organisms. In Resnick D, ed. Bone and Joint Imaging. Philadelphia, PA: Saunders 1989:753-788.
  4. Pineda C, Espinosa R, Pena A. Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy. Semin Plast Surg 2009;23:80-89 https://doi.org/10.1055/s-0029-1214160
  5. Peh WC, Khong PL, Yin Y, Ho WY, Evans NS, Gilula LA, et al. Imaging of pelvic insufficiency fractures. Radiographics 1996;16:335-348 https://doi.org/10.1148/radiographics.16.2.8966291
  6. Hayes CS, Heinrich SD, Craver R, MacEwen GD. Subacute osteomyelitis. Orthopedics 1990;13:363-366
  7. Mhuircheartaigh JN, Lin YC, Wu JS. Bone tumor mimickers: a pictorial essay. Indian J Radiol Imaging 2014;24:225-236 https://doi.org/10.4103/0971-3026.137026
  8. Khung S, Budzik JF, Amzallag-Bellenger E, Lambilliote A, Soto Ares G, Cotten A, et al. Skeletal involvement in Langerhans cell histiocytosis. Insights Imaging 2013;4:569-579 https://doi.org/10.1007/s13244-013-0271-7
  9. Kaul R, Gupta N, Gupta S, Gupta M. Eosinophilic granuloma of skull bone. J Cytol 2009;26:156-157 https://doi.org/10.4103/0970-9371.62188
  10. Joo I, Choi JA, Chung JH, Oh JH, Hong SH, Kang HS. Fibroblastic type osteosarcoma of the ulna: a case report of a tumor in a rare location with atypical imaging findings. Korean J Radiol 2009;10:85-88 https://doi.org/10.3348/kjr.2009.10.1.85
  11. Sundaram M, Totty WG, Kyriakos M, McDonald DJ, Merkel K. Imaging findings in pseudocystic osteosarcoma. AJR Am J Roentgenol 2001;176:783-788 https://doi.org/10.2214/ajr.176.3.1760783
  12. Perron AD, Brady WJ, Miller MD. Orthopedic pitfalls in the ED: osteomyelitis. Am J Emerg Med 2003;21:61-67 https://doi.org/10.1053/ajem.2003.50013
  13. Khanna G, Sato TSP, Ferguson P. Imaging of chronic recurrent multifocal osteomyelitis. Radiographics 2009;29:1159-1177 https://doi.org/10.1148/rg.294085244
  14. Giurato L, Uccioli L. The diabetic foot: Charcot joint and osteomyelitis. Nucl Med Commun 2006;27:745-749 https://doi.org/10.1097/01.mnm.0000230066.23823.cc
  15. Vander Cruyssen B, Munoz-Gomariz E, Font P, Mulero J, de Vlam K, Boonen A, et al.; ASPECT-REGISPONSER-RESPONDIA working group. Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Rheumatology (Oxford) 2010;49:73-81 https://doi.org/10.1093/rheumatology/kep174
  16. Jeong H, Eun YH, Kim IY, Kim H, Lee J, Koh EM, et al. Characteristics of hip involvement in patients with ankylosing spondylitis in Korea. Korean J Intern Med 2017;32:158-164 https://doi.org/10.3904/kjim.2015.229
  17. Hong SH, Choi JY, Lee JW, Kim NR, Choi JA, Kang HS. MR imaging assessment of the spine: infection or an imitation? Radiographics 2009;29:599-612 https://doi.org/10.1148/rg.292085137
  18. Shah LM, Salzman KL. Imaging of spinal metastatic disease. Int J Surg Oncol 2011;2011:769753
  19. Khattry N, Thulkar S, Das A, Khan SA, Bakhshi S. Spinal tuberculosis mimicking malignancy: atypical imaging features. Indian J Pediatr 2007;74:297-298 https://doi.org/10.1007/s12098-007-0049-3