Literature DB >> 17515372

Imaging-guided bone biopsy for osteomyelitis: are there factors associated with positive or negative cultures?

Jim S Wu1, Tetyana Gorbachova, William B Morrison, Andrew H Haims.   

Abstract

OBJECTIVE: The objective of our study was to identify the clinical and technical factors associated with positive or negative culture results in histologically positive cases of osteomyelitis obtained from imaging-guided bone biopsies.
MATERIALS AND METHODS: A retrospective review was performed of 800 consecutive patients undergoing imaging-guided core bone biopsies at two institutions. Seventy-five biopsies were performed for suspected osteomyelitis and 41 patients had histologically proven osteomyelitis. A chart review was performed to determine whether the following factors affected the culture result: histologic type of osteomyelitis, antibiotic therapy before biopsy, fever (temperature > or = 38.0 degrees C), elevated WBC count (> or = 10 x 10(3) microL), elevated erythrocyte sedimentation rate (ESR) (> or = 10 mm/h), elevated C-reactive protein value (CRP) (> or = 6 mg/L), the size of the biopsy needle, and the amount of purulent fluid obtained at biopsy.
RESULTS: Of the 41 cases of osteomyelitis, 14 (34%) had positive cultures. Eighteen (44%) of 41 cases were chronic osteomyelitis. Seventeen (41%) of 41 patients received antibiotics before biopsy, seven (17%) were febrile, five (12%) had an elevated WBC count, 16 (39%) had an elevated ESR, and six (15%) had an elevated CRP value. The biopsy needle size ranged from 11- to 18-gauge. These factors did not have any significant association with positive or negative culture results. Purulent fluid was aspirated in 10 (24%) of the 41 cases. In six (15%) of the cases, > or = 2 mL of purulent fluid was aspirated and five (83%) of the six cases were associated with positive culture (p = 0.02).
CONCLUSION: The rate of positive culture results in histologically proven cases of osteomyelitis obtained from imaging-guided bone biopsies is low. Aspirating > or = 2 mL of purulent fluid is associated with a significantly higher rate of positive cultures.

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Year:  2007        PMID: 17515372     DOI: 10.2214/AJR.06.1286

Source DB:  PubMed          Journal:  AJR Am J Roentgenol        ISSN: 0361-803X            Impact factor:   3.959


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