Diagnosis of peripheral bone and prosthetic joint infections: overview on the consensus documents by the EANM, EBJIS, and ESR (with ESCMID endorsement)

Luca Maria Sconfienza, Alberto Signore, Victor Cassar-Pullicino, Maria Adriana Cataldo, Olivier Gheysens, Olivier Borens, Andrej Trampuz, Klaus Wörtler, Nicola Petrosillo, Heinz Winkler, Filip M.H.M. Vanhoenacker, Paul C. Jutte, Andor W.J.M. Glaudemans

Research output: Contribution to journalArticle

Abstract

Objectives: Peripheral bone infection (PBI) and prosthetic joint infection (PJI) are two different infectious conditions of the musculoskeletal system. They have in common to be quite challenging to be diagnosed and no clear diagnostic flowchart has been established. Thus, a conjoined initiative on these two topics has been initiated by the European Society of Radiology (ESR), the European Association of Nuclear Medicine (EANM), the European Bone and Joint Infection Society (EBJIS), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). The purpose of this work is to provide an overview on the two consensus documents on PBI and PJI that originated by the conjoined work of the ESR, EANM, and EBJIS (with ESCMID endorsement). Methods and results: After literature search, a list of 18 statements for PBI and 25 statements for PJI were drafted in consensus on the most debated diagnostic challenges on these two topics, with emphasis on imaging. Conclusions: Overall, white blood cell scintigraphy and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities for the diagnosis of PBI and PJI. However, the choice of which advanced diagnostic modality to use first depends on several factors, such as the benefit for the patient, local experience of imaging specialists, costs, and availability. Since robust, comparative studies among most tests do not exist, the proposed flowcharts are based not only on existing literature but also on the opinion of multiple experts involved on these topics. Key Points: • For peripheral bone infection and prosthetic joint infection, white blood cell and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities. • Two evidence- and expert-based diagnostic flowcharts involving variable combination of laboratory tests, biopsy methods, and radiological and nuclear medicine imaging modalities are proposed by a multi-society expert panel. • Clinical application of these flowcharts depends on several factors, such as the benefit for the patient, local experience, costs, and availability.

Original languageEnglish
Pages (from-to)1-14
Number of pages14
JournalEuropean Radiology
DOIs
Publication statusE-pub ahead of print - Jun 27 2019

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Nuclear Medicine
Microbiology
Radiology
Communicable Diseases
Joints
Bone and Bones
Infection
Software Design
Leukocytes
Magnetic Resonance Imaging
Costs and Cost Analysis
Musculoskeletal System
Expert Testimony
Radionuclide Imaging

Keywords

  • Clinical laboratory techniques
  • Nuclear medicine
  • Osteomyelitis
  • Prosthesis-related infections
  • Radiology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Diagnosis of peripheral bone and prosthetic joint infections : overview on the consensus documents by the EANM, EBJIS, and ESR (with ESCMID endorsement). / Sconfienza, Luca Maria; Signore, Alberto; Cassar-Pullicino, Victor; Cataldo, Maria Adriana; Gheysens, Olivier; Borens, Olivier; Trampuz, Andrej; Wörtler, Klaus; Petrosillo, Nicola; Winkler, Heinz; Vanhoenacker, Filip M.H.M.; Jutte, Paul C.; Glaudemans, Andor W.J.M.

In: European Radiology, 27.06.2019, p. 1-14.

Research output: Contribution to journalArticle

Sconfienza, Luca Maria ; Signore, Alberto ; Cassar-Pullicino, Victor ; Cataldo, Maria Adriana ; Gheysens, Olivier ; Borens, Olivier ; Trampuz, Andrej ; Wörtler, Klaus ; Petrosillo, Nicola ; Winkler, Heinz ; Vanhoenacker, Filip M.H.M. ; Jutte, Paul C. ; Glaudemans, Andor W.J.M. / Diagnosis of peripheral bone and prosthetic joint infections : overview on the consensus documents by the EANM, EBJIS, and ESR (with ESCMID endorsement). In: European Radiology. 2019 ; pp. 1-14.
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AU - Cassar-Pullicino, Victor

AU - Cataldo, Maria Adriana

AU - Gheysens, Olivier

AU - Borens, Olivier

AU - Trampuz, Andrej

AU - Wörtler, Klaus

AU - Petrosillo, Nicola

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