J Korean Soc Radiol.  2017 Jul;77(1):53-56. 10.3348/jksr.2017.77.1.53.

MRI Findings of Post-Traumatic Osteomyelitis of Distal Phalanx Following Neglected Open Fracture

• Kim DE
• Lee J
• Bae KE
• Kang MJ
• Kim JH
• Cho WH
• Jeong MJ
• Kim SH
• Kim JY
• Kim SH

• KMID: 2384736
• DOI: http://doi.org/10.3348/jksr.2017.77.1.53

Abstract

Careful radiologic examination of the osteolytic lesion is important for patients with fracture. Differential diagnosis includes osteonecrosis, neoplasm and infections. In this report, we presented MRI findings of post-traumatic osteomyelitis following neglected open fracture of 3rd distal phalanx with open wound. Early suspicion and imaging of wound or soft tissue inflammation around osteolytic lesion could be helpful for diagnosis of osteomyelitis.

MeSH Terms

Diagnosis
Diagnosis, Differential
Finger Phalanges
Fractures, Open*
Humans
Inflammation
Magnetic Resonance Imaging*
Osteomyelitis*
Osteonecrosis
Wounds and Injuries

Figure

• 

  Fig. 1 Simple radiographs and MRI findings of post-traumatic osteomyelitis of distal phalanx following neglected open fracture in a 15-year-old male. A, B. Simple radiographs of anteroposterior (A) and lateral (B) views of 3rd finger show ill-defined osteolytic lesion with cortical defect in dorsal side of 3rd distal phalanx. C-F. MR images of the 3rd finger. Coronal fat-saturated proton density image (C), sagittal fat-saturated proton density image (D), coronal T1 weighted image (E), and sagittal fat-saturated T1 weighted image with gadopentate dimeglumine enhancement (F). MRI images reveal ill-defined osteolytic lesion in base of 3rd distal phalanx. The lesion was hyperintense on fat-saturated proton density images (C, D, arrows) and hypointense on fat-saturated T1 weighted images (E, arrow). After enhancement, the lesion showed focal peripheral enhancement (F, arrow). In skin and subcutaneous layer, linear-shaped dark signal lesion toward the osteolytic lesion was also noted on fat-saturated T1 weighted images with enhancement (F, arrowhead).

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