II. Indications

  1. First line study in Osteomyelitis evaluation due to low cost and high availability
  2. Narrows Osteomyelitis differential diagnosis by ruling out other causes
    1. Metastases to bone
    2. Osteoporotic Fractures

III. Findings: Early

  1. Soft tissue swelling
  2. Periosteal reaction (Subperiosteal elevation)

IV. Findings: Later

  1. Osteolysis
  2. Sequestra (islands of necrotic bone)
  3. Bone abscess (Brodie's abscess)

VI. Limitations

  1. Bone changes lag infection by 10-20 days
  2. XRay changes not seen until 40-70% bone resorbed
  3. Repeat XRay at 2 week intervals

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