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A DIFFERENT PERSPECTIVE FOR RADIOLOGICAL EVALUATION OF EXPERIMENTAL OSTEOMYELITIS



Abstract

Radiological evaluation is crucial for interpretation of experimental osteomyelitis studies. Current scoring systems for radiologic evaluation of experimental osteomyelitis have limitations to demonstrate differences among treatment groups. Response of bone tissue to infection is a dynamic process; each radiological sign of osteomyelitis becomes prominent at different time points of disease. Analysing radiological criteria separately at different stages of the disease may provide better quantification of the response to treatment in experimental osteomyelitis rather than summation of these grades together.

Osteomyelitis was induced with S.aureus in left tibias of 72 adult, wistar albino rats. Rats were assigned into six different treatment groups. Their radiograms were graded according to previously defined scoring systems, and each radiological criterion separately, at the third week of induction, and at the third and sixth week after treatment.

Although periosteal reaction and diaphyseal widening demonstrate significant differences with three weeks of treatment, previously defined scoring systems could not find significant differences. At the sixth week of treatment, only one of the previously defined grading scales was able to differentiate significance among the treatment groups. Individual values of diaphyseal widening, osteolysis, BMC values were pointed out differences among the groups in the presence of osteomyelitis, confirmed by osteomyelitis.

Formulation of radiological grading scales requires evaluation of periosteal elevation, diaphyseal widening, bone deformation, osteolysis, and osteosclerosis, individually. However, evaluation of these scores separately will multiply interpretations of future studies, and will make them more meaningful.



Correspondence should be addressed to Vasiliki Boukouvala at Department of Orthopaedic Surgery & Traumatology, University Hospital of Larissa, 110 Mezourlo, Larissa, GREECE. Tel: +30 2410 682722, Fax: +30 2410 670107, Email: malizos@med.uth.gr