Osteomyelitis

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The purpose of this seemingly complicated approach to osteomyelitis is to streamline the protocol so we can perform the exams on a consistent basis to obtain adequate diagnostic information within a reasonable amount of scanning time.

For all osteomyelitis cases, post contrast sequences are needed for evaluation of bone viability. If intravenous contrast cannot be administered due to severe renal insufficiency or allergy, please refer to routine protocol to scan the patient.

Ulcers should be marked before scanning is initiated.

Please acquire sequences in the order listed in the protocol.

If there is difficulty completing the last post contrast sequence (e.g. pt. motion, pt. pain, scanner shut down etc.), there is no need to repeat the specific sequence

Foot osteomyelitis


Osteomyelitis forefoot or midfoot (ulcer at tip of foot - distal ulcer)

If ulcer at medial or lateral foot, choose short axis plane for pre and post contrast T1 FS. Optional post contrast sequence: cor post contrast T1 FS


Osteomyelitis forefoot or midfoot (ulcer at dorsal or plantar foot)


Osteomyelitis forefoot or midfoot (ulcer at medial or lateral foot)


Ankle / hindfoot osteomyelitis

Setup as ankle MR

ax - axial to tibia/fibula

cor - coronal distal tibial sigmoid notch

sag - perpendicular to coronal plane


Osteomyelitis hindfoot or ankle (ulcer at posterior hindfoot / ankle)


Osteomyelitis hindfoot or ankle (ulcer at dorsal or plantar hindfoot)


Osteomyelitis hindfoot or ankle (ulcer at medial or lateral hindfoot / ankle)


Osteomyelitis post surgical stump (below the knee or above the knee amputation)


Other long bone osteomyelitis

Please refer to ankle osteomyelitis for plane selection of pre and post contrast sequences.