The use of intravenous contrast in MRI of extremity infection.

Infection of the musculoskeletal system encompasses a variety of conditions, affecting skin, fascia, muscle, joints, tendon sheaths, and bone. In addition to features unique to each tissue site, these processes vary with respect to organism virulence, overall host condition, and the condition of the extremity itself, particularly its circulation. Treatment of musculoskeletal infection varies according to these features, and with respect to the presence of devitalized tissue. Unfortunately, while clinical examination is accurate for the presence of infection as a process in most circumstances, it lacks specificity for the variety of disorders within the spectrum of extremity infection. MRI examination using intravenous contrast is becoming the preferred modality to study complicated extremity infections, since it provides an accurate portrayal of the extent of osseous and non osseous involvement, and identifies areas of necrosis. This information provides a basis from which clinicians may more accurately choose from among treatment options.