Acute suppurative osteomyelitis Radiology ========================================================================= •Plain films: irregular radioleucency, adjacent fracture site (if present), osteomyelitis •CT: lytic permeative changes with soft tissue inflammation •Magnetic Resonance Imaging: less often affected than CT by dental amalgam artifact; if amalgam obscures, can perform MR to help detect abscess •Bone scintigraphy: sensitive for osteomyelitis; radiolabeled white blood cell scintigraphy has proven to be useful for detecting septic activity in the jaw bone Differential diagnosis ========================================================================= •Acute exacerbation of bisphosphonate osteonecrosis •Infected cemento-osseous dysplasia •Langerhan cell histiocytosis •Metastatic disease to jaws, with abscess •Periapical granuloma with abscess FIGURES Clinical findings at the initial visit. (a) Close-up view of the socket in the left mandibular first molar region. (b) Panoramic radiograph showing neither abnormal consolidation nor ill-defined trabecular bone structure around the socket and clear running of the inferior alveolar arteries. CT scans at 14 days after the initial visit showing remarkable absorption of the cortical bone in the left mandibular molar region. (a) Axial section. (b) Coronal section.
Posted on: Sat, 18 Oct 2014 14:42:40 +0000
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