Journal of Ultrasound in Medicine, Vol 13, Issue 9 707-709, Copyright © 1994 by American Institute of Ultrasound in Medicine
How useful is ultrasonography in suspected acute osteomyelitis?
G. Larcos, V. F. Antico, W. Cormick, S. M. Gruenewald and D. C. Farlow
Department of Nuclear Medicine and Ultrasound, Westmead Hospital, Australia.
Sonographically detected subperiosteal fluid and periosteal irregularity
have recently been proposed as diagnostic features of osteomyelitis. The
purpose of this study was to determine the diagnostic accuracy of
ultrasonography for suspected osteomyelitis. Nineteen patients were
investigated prospectively with high-resolution ultrasonography for the
presence of subperiosteal fluid or cortical irregularity. Diagnosis was
established by surgery (three cases) or by results of other tests and
clinical follow-up. Sixteen patients were diagnosed as having
osteomyelitis, with positive ultrasonography in ten (sensitivity = 63%).
Two ultrasonographic studies were false-positive; diagnostic accuracy was
58%. Thus, ultrasonographic results may be potentially misleading,
emphasizing the importance of clinical judgment and results of other tests.
