Role of MRI in the diagnosis and treatment of osteomyelitis in pediatric patients

Figure 8 Transphyseal methicillin-resistant Staphylococcus aureus osteomyelitis with intraosseous abscess. A: Coronal T1-weighted image of the right ankle shows an area of T1 hyperintensity in the distal tibial metaphysis with central T1 hypointensity (solid long arrow) indicative of abscess formation. T1 hypointensity is seen surrounding this area in metaphysis (solid short arrow) and in the epiphysis (dashed arrow) indicative of transphyseal spread; B: Coronal T2-weighted image with fat suppression shows an area of T2 hypointensity with central T2 hyperintensity (solid long arrow) corresponding to the areas of abnormal T1 signal in A. T2 hyperintensity in the distal metaphysis (solid short arrow) and epiphysis (dashed arrow) are consistent with edema. T2 hyperintensity in periosteum and adjacent soft tissues indicating inflammation (arrowhead); C: Coronal T1-weighted image post contrast shows a lack of enhancement in the central distal metaphysis consistent with necrosis and abscess formation (solid long arrow). Enhancement is seen peripherally in the distal metaphysis and epiphysis (solid short arrow and dashed arrow). Enhancement in periosteum and adjacent soft tissues indicating inflammation (arrowhead).