E5341. Musculoskeletal Infections Presenting in the ER: A Primer For Trainees
Authors
Ahmed Taher;
The University of Texas Health Science Center at Houston
Manickam Kumaravel;
The University of Texas Health Science Center at Houston
Serag Attia;
No Affiliation
Vikram Vijayarajan;
The University of Texas Health Science Center at Houston
Aashini Patel;
The University of Texas Health Science Center at Houston
Grace Miles;
The University of Texas Health Science Center at Houston
Aashini Patel;
The University of Texas Health Science Center at Houston
Background
Musculoskeletal (MSK) infection constitutes one of the true radiological imaging emergencies. Utilizing the appropriate imaging approach for different musculoskeletal soft tissue infections is crucial for swift diagnosis, effective treatment, and minimizing the potential for complications arising from incorrect or delayed diagnoses. The specific imaging strategy can vary widely based on the extent of involvement across various layers of soft tissues. The aim of this exhibit is to provide a practical overview of the imaging features for the main MSK and soft tissue infections in the emergency department and help radiology trainees to accurately identify them.
Educational Goals / Teaching Points
1. Highlight the importance of obtaining history and having a high clinical suspicion for rapid interventions. 2. Delineate the differences between soft tissue and MSK infections. 3. Describe the wide range of MSK infectious conditions that are commonly encountered in emergency departments. 4. Illustrate the key imaging findings using different modalities to characterize soft tissue infections and to identify the location and extent of involvement.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
CT and MRI have become crucial in diagnosing various types of such infections. Cross-sectional imaging methods are especially valuable in examining soft tissue infections and they give more precise information about the extent of the infection and anatomical structures involved. MRI stands out as the most comprehensive and sensitive tool for assessing musculoskeletal infections. Ultrasound also holds significance, particularly for assessing diseases close to the skin's surface and guiding procedures like biopsies, needle aspirations, and drainage using ultrasound guidance. Conventional radiography is notably useful, especially in identifying foreign objects and cases of infections with delayed diagnoses that exhibit bone involvement.
Conclusion
Patients presenting at emergency care due to MSK infections can exhibit a wide range of symptoms. These can span from persistent wounds and general bone or joint discomfort to potential neurological issues and significant functional impairment. In such scenarios, timely and accurate diagnosis facilitated by imaging is essential for delivering optimal patient care.
