MRI can eliminate needless surgery for children with musculosketal infections

Pre-treatment MRI can eliminate unnecessary diagnostic or surgical procedures for children with suspected musculoskeletal infections (septic arthritis and osteomyelitis), according to a study published in the November issue of the American Journal of Roentgenology.

Researchers from Vanderbilt Children's Hospital in Nashville, Tenn., examined 130 children with suspected musculoskeletal infections—34 patients in the study group had an MRI after diagnostic or therapeutic intervention and 96 patients in the control group had an MRI prior to any procedure.

The findings showed that about 60 percent of patients had neither septic arthritis nor osteomyelitis, suggesting that “the majority of the children in the study group had a diagnostic or surgical procedure which could have been avoided with early MRI evaluation,” said the study’s lead author J. Herman Kan, MD.

Kan noted that MRI is not routinely performed prior to treatment because of concerns regarding time and treatment delay and patient sedation.

“If your pediatrician or orthopedic surgeon has a clinical concern for musculoskeletal infection, MRI plays a valuable role in the evaluation of your child's symptoms,” he said. “Even if there is a delay in diagnosis or if your child needs to be sedated for an MRI, MRI performed prior to invasive procedures will potentially eliminate the need for a diagnostic or surgical intervention altogether.”

“In addition, if osteomyelitis or septic arthritis is present and treatment is indeed necessary, MRI performed first will potentially decrease operative time because MRI can provide a roadmap for the orthopedic surgeon,” Kan concluded.