Musculoskeletal Infections: Clinical Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 10 September 2024 | Viewed by 926

Special Issue Editors


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Guest Editor
Department of Orthopaedics and Traumatology, “Venizeleion” General Hospital of Crete, 71409 Heraklion, Greece
Interests: spinal surgery; trauma; biomaterials
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Guest Editor
1. Department of Medical Imaging, University Hospital, 71500 Heraklion, Greece
2. Department of Radiology, School of Medicine, University of Crete, 71003 Heraklion, Greece
3. Advanced Hybrid Imaging Systems, Institute of Computer Science, FORTH, 71500 Heraklion, Greece
Interests: imaging of musculoskeletal disorders; applications of newer MR sequences; image-guided treatments

Special Issue Information

Dear Colleagues,

The interest in the diagnosis and treatment of musculoskeletal infections has grown in recent decades, requiring a multidisciplinary approach. On the one hand, unusual pathogens appear to affect the musculoskeletal tissues, and on the other hand, common pathogens have become difficult to eradicate because of antimicrobial resistance development from extensive antibiotic use. Furthermore, a growing number of patients undergoing orthopedic procedures for trauma, degenerative, and other disorders receive orthopedic implants. Surgical site infection following orthopedic surgery with instrumentation is a serious and relatively common complication, which potentially compromises surgical outcomes and increases the overall morbidity and mortality. In addition, musculoskeletal infections have increased due to the fact that many patients undergo image-guided diagnostic and therapeutic procedures and that an increasing number of patients are immunocompromised and thus vulnerable to severe and atypical infections. Iatrogenic infections often result in prolonged hospital stays, readmissions, reoperations, and long-term intravenous antibiotics and significantly increase the cost of care.

The choice of appropriate treatment is often complex and involves the consideration of multiple factors, such as soft-tissue and implant conditions, the duration and severity of the infection, the underlying pathogen, and the patient’s morbidity and functional status.

The early involvement of multidisciplinary teams, analogous to oncological boards, consisting of radiologists, infectious diseases specialists, and orthopedic surgeons, is important to achieve the optimal result for the patient. The evolution of imaging modalities, such as high-field MRI and newer CT scanners with metal artifact reduction techniques, advanced image analysis based on radiomics, and deep learning as well as newer tracers with PET/CT, provide valuable diagnostic capabilities, which have modified the conventional diagnostic algorithm.

This Special Issue invites the participation of specialists from different scientific fields including infectious diseases, orthopedic surgery, rheumatology, and radiology.

Topics such as the diagnosis and treatment of primary bone and joint infection in children and adults and the diagnosis and treatment as well as the preventive measures of prosthetic joint infections are within the scope of this Special Issue. Studies focusing on infections caused by uncommon and difficult-to-treat pathogens such as mycobacterial or fungal infections, spinal infections, and infections related to polytrauma patients are also welcome. Finally, we are interested in imaging studies.

As editors of this Special Issue, we hope to provide a scientific overview of radiological, clinical, surgical, and epidemiological contributions, describing recent advances that can lead to improvements in diagnosis, treatment, and prognosis in the field of musculoskeletal infections.

Dr. Kalliopi Alpantaki
Prof. Dr. Apostolos Karantanas
Guest Editors

Manuscript Submission Information

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Keywords

  • computed tomography
  • magnetic resonance
  • musculoskeletal infections
  • septic arthritis
  • osteomyelitis
  • fungal infections
  • mycobacterium infections
  • prosthetic joint infections
  • postoperative infections
  • surgical treatment
  • VAC
  • hyperbaric oxygen

Published Papers (1 paper)

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15 pages, 3738 KiB  
Systematic Review
Evaluating Imaging Techniques for Diagnosing and Drainage Guidance of Psoas Muscle Abscess: A Systematic Review
by Murtadha Qais Al-Khafaji, Mohammad Walid Al-Smadi, Mustafa Qais Al-Khafaji, Siran Aslan, Yousif Qais Al-Khafaji, Panna Bagossy-Blás, Mohammad Hakem Al Nasser, Bálint László Horváth and Árpád Viola
J. Clin. Med. 2024, 13(11), 3199; https://doi.org/10.3390/jcm13113199 - 29 May 2024
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Abstract
Background: Psoas muscle abscess (PMA) is an uncommon yet severe condition characterized by diagnostic and therapeutic challenges due to its varied etiology and nonspecific symptoms. This study aimed to evaluate the effectiveness and accuracy of various imaging techniques used in the image-guided percutaneous [...] Read more.
Background: Psoas muscle abscess (PMA) is an uncommon yet severe condition characterized by diagnostic and therapeutic challenges due to its varied etiology and nonspecific symptoms. This study aimed to evaluate the effectiveness and accuracy of various imaging techniques used in the image-guided percutaneous drainage (PD) of PMA. Methods: A systematic review was conducted following the PRISMA guidelines. We searched PubMed, Google Scholar, and Science Direct for studies published in English from 1998 onwards that reported on the use of PD in treating PMA, detailing outcomes and complications. Imaging modalities guiding PD were also examined. Results: We identified 1570 articles, selecting 39 for full review. Of these, 23 met the inclusion criteria; 19 were excluded due to unspecified PMA, absence of imaging guidance for PD, or inconclusive results. Eleven studies utilized computed tomography (CT) for PD, with six also using magnetic resonance imaging (MRI). Ten studies implemented ultrasound (US)-guided PD; variations in diagnostic imaging included combinations of US, CT, and MRI. A mixed approach using both CT and US was reported in two articles. Most studies using CT-guided PD showed complete success, while outcomes varied among those using US-guided PD. No studies employed MRI-guided PD. Conclusions: This review supports a multimodal approach for psoas abscess management, using MRI for diagnosis and CT for drainage guidance. We advocate for Cone Beam CT (CBCT)-MRI fusion techniques with navigation systems to enhance treatment precision and outcomes, particularly in complex cases with challenging abscess characteristics. Full article
(This article belongs to the Special Issue Musculoskeletal Infections: Clinical Diagnosis and Treatment)
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