In suspected chronic osteomyelitis, when should bone biopsy follow MRI? скачать в хорошем качестве

In suspected chronic osteomyelitis, when should bone biopsy follow MRI?

This discussion addresses the diagnostic approach to suspected chronic osteomyelitis in adults, focusing on the decision between magnetic resonance imaging (MRI) and bone biopsy. The core clinical question is when MRI is sufficient and when biopsy is required to confirm infection and guide antimicrobial therapy. Although MRI is highly sensitive and noninvasive, its specificity is limited in complex scenarios such as hardware-associated infection, malignancy, or extensive soft tissue involvement. Bone biopsy remains the definitive standard for histopathologic and microbiologic confirmation but carries procedural risks. A stepwise framework is outlined: begin with MRI for initial assessment, proceed to biopsy when imaging is inconclusive or pathogen identification is necessary, and reassess if clinical suspicion persists despite negative sampling. The emphasis is on aligning diagnostic certainty with treatment decisions while minimizing unnecessary procedures. #InfectiousDisease #Osteomyelitis #DiagnosticImaging #Orthopedics #ClinicalDecisionMaking