MR imaging findings in 7 patients with unusual manifestations of vertebral osteomyelitis
Patient No. | Involved Bones* | Intraosseous Lesions | SI of Intraosseous Lesions | Enhancement of Intraosseous Lesions | Rim Sign | Halo Sign | Preservation of Intervertebral Disks | Soft-Tissue Inflammation† | ||
---|---|---|---|---|---|---|---|---|---|---|
T1W | T2W | STIR | ||||||||
1 | Spine (L5) | Solitary | ↓ | −− or ↑ | ↑ | Global | Yes | Yes | Yes | Yes |
2 | Spine (S1) | Solitary | ↓ | ↑ | ↑ | Global | Yes | Yes | Yes | Yes |
3 | Spine (T10, L1, upper sacrum) | Multiple | ↓ | ↑ | ↑ | Global | Yes | Yes | Yes | Yes |
4 | Spine (T5-L5, upper sacrum), bilateral pelvic girdles | Multiple | ↓ | −− or ↑ | ↑ | Global or marginal | No | Yes | Yes | Yes |
5 | Spine (whole spine), bilateral ribs | Multiple | ↓ | −− or ↑ | ↑ | Global | Yes | Yes | Yes | No |
6 | Spine (whole spine) | Multiple | ↓ | −− or ↑ | ↑ | Global or marginal | Yes | Yes | Yes | Yes |
7 | Spine (whole spine), bilateral ribs, sternum, bilateral pectoral girdles, bilateral pelvic girdles | Multiple | ↓ | −− or ↑ | ↑ | Global or marginal | Yes | Yes | Yes | Yes |
Note:—SI indicates signal intensity; T1W, T1-weighted MR images; T2W, T2-weighted MR images; STIR, short τ inversion recovery; ↑, hyperintense; −−, isointense; ↓, hypointense.
* Posterior element involvement of the vertebrae is noted in 3 patients (patients 5–7).
† Limited amount of the paraspinal or epidural inflammatory tissue is noted in 6 patients (patients 1–4, 6, and 7).