| Institution: | 1. Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California;2. Section of Radiology, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy;1. Department of Radiology, Hanoi Medical University Hospital, Hanoi, Vietnam;2. Department of Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam;3. Department of Diagnostic Radiology, Keio University, Tokyo, Japan;4. Department of Respiratory Medicine, Hanoi French Hospital, 1 Phuong Mai St., Dong Da District, 10000 Hanoi, Vietnam;1. Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016;2. Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;3. Department of Radiology, Virginia Tech Carilion School of Medicine, Carilion Clinic, Roanoke, Virginia;1. Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Jena, Jena, Germany;2. Institut für Medizinische Statistik, Informatik und Dokumentation, Universitätsklinikum Jena, Jena, Germany;3. Klinik und Poliklinik für Urologie, Universitätsklinikum Jena, Jena, Germany;1. Department of Emergency Medicine, University of New Mexico School of Medicine, MSC11, 6025 Lomas Blvd. NE, Albuquerque, NM 87131-0001;2. Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico |
| Abstract: | PurposeTo assess diagnostic performance of CT-guided percutaneous needle bone biopsy (CTNBB) in patients with suspected osteomyelitis and analyze whether certain clinical or technical factors were associated with positive microbiology results.Materials and MethodsAll CTNBBs performed in a single center for suspected osteomyelitis of the appendicular and axial skeleton during 2003–2018 were retrospectively reviewed. Specific inclusion criteria were clinical and radiologic suspicion of osteomyelitis. Standard of reference was defined using outcome of surgical histopathology and microbiology culture and clinical and imaging follow-up. Technical and clinical data (needle size, comorbidities, clinical factors, laboratory values, blood cultures) were collected. Logistic regression was performed to assess associations between technical and clinical data and microbiology biopsy outcome.ResultsA total of 142 CTNBBs were included (46.5% female patients; age ± SD 46.10 y ± 22.8), 72 (50.7%) from the appendicular skeleton and 70 (49.3%) from the axial skeleton. CTNBB showed a sensitivity of 42.5% (95% confidence interval CI], 32.0%–53.6%) in isolating the causative pathogen. A higher rate of positive microbiology results was found in patients with intravenous drug use (odds ratio OR] = 5.15; 95% CI, 1.2–21.0; P = .022) and elevated white blood cell count ≥ 10 × 109/L (OR = 3.9; 95% CI, 1.62–9.53; P = .002). Fever (≥ 38°C) was another clinical factor associated with positive microbiology results (OR = 3.6; 95% CI, 1.3–9.6; P = .011).ConclusionsCTNBB had a low sensitivity of 42.5% for isolating the causative pathogen. Rate of positive microbiology samples was significantly higher in patients with IV drug use, elevated white blood cell count, and fever. |
