Assessment of bone quality by the technique of multispiral computer tomography in patients with chronic osteomyelitis

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Purpose - to study the roentgenomorphological features of the lower limb long bones in patients with chronic osteomyelitis using the technique of multi-spiral computer tomography (MSCT), and to propose the complex of parameters to assess bone quality. Material and methods. Roentgenography and computer tomography of the hips were performed in 49 patients with chronic osteomyelitis of long bones of lower extremities. The studies made using computer tomographs GE Light Speed VCT, Toshiba Aquilion-64, Somatom Smile. Results. The changes in bone structure of proximal femur were characterized by extremely marked polymorphism, and they almost didn’t repeat in the anatomical component. The cortical plate had heterogenous structure with resorption zones in the area of its transfer to the shaft. The character of roentgenomorphological changes in the shaft was individual in all the patients, but there were common manifestations as well which consisted in thickening of the cortical plate, different intensity of periosteal and endosteal layers. The cortical plate was significantly different in density, which exceeded 1700 HU in some places. When osteomyelitic process localized in the knee marked changes affected its all components, they manifested themselves in extended osteoporosis and local osteosclerosis. When osteomyelitic process localized in proximal tibia extensive resorption zones observed, the cortical plate thinned in proximal parts, its density was not more than 350 HU. Conclusion. The data demonstrated that bone quality in patients with chronic osteomyelitis had significant deviations from normal values in terms of changing both its density and architectonics. The deviations consisted in bone density decrease in the meta-epiphyseal part regardless of the process localization, in highly variable density values of the cortical plate as a result of its thickening or thinning, presence of resorption or sclerosis areas.

About the authors

G. V. Dyachkova

Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»

Author for correspondence.
Russian Federation

K. A. Dyachkov

Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»

Russian Federation

S. M. Aleksandrov

Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»

Russian Federation

T. A. Larionova

Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»

Russian Federation

N. M. Klyushin

Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»

Russian Federation


  1. Гайдышев И. П. Анализ и обработка данных: специальный справочник. СПб.: Питер; 2001:752с
  2. Гаркавенко Ю. Е., Красногорский И. Н. Морфологическая оценка последствий гематогенного остеомиелита длинных костей у детей. Травматология и ортопедия России. 2012;( 3); 27-34
  3. Гостищев В. К., Липатов К. В., Писаренко Л. В., Рубин М. П., Стан Е. А., Маракуца Е. В. Прогнозирование изменений прочности длинных трубчатых костей в хирургии хронического остеомиелита . Хирургия. Журн. им. Н. И. Пирогова. 2010;( 2): 4-6
  4. Дьячкова Г. В., Митина Ю. Л. КТ-семиотика пролиферативных изменений в бедренной кости при хроническом остеомиелите, развившемся после острого гематогенного остеомиелита. Вестн. травматологии и ортопедии им. Н. Н. Приорова.2011;( 4): 60-64
  5. Житницкий Р. Е., Виноградов В. Г., Шапурма Д. Г. Хронический травматический остеомиелит длинных костей .Иркутск. : Изд-во Иркут. ун-та; 1989. 104с
  6. Кармазановский Г. Г. Лучевая диагностика хронического остеомиелита длинных костей. Мед. визуализация. 1997;( 3): 54-58
  7. Кармазановский Г.Г., Шуракова А.Б. Магнитно-резонансно-томографическая диагностика остеомиелита. М. : Видар-М; 2011. 72 с
  8. Никитин Г. Д., Рак A. B., Линник С. А., Салдун Г. П., Кравцов А. Г., Агафонов Н. А., Фахрутдинов Р. З., Хаймин В. В. Хирургическое лечение остеомиелита. СПб. ,2000. 286 с
  9. Усик С. Ф., Федосеев М. М., Братийчук А. Н., Анипченко А. Н. Остеомиелит: клиника, диагностика, лечение : учеб. Пособие. Саратов., 2007. 96 с
  10. Шевцов В. И., Лапынин А. И., Ларионова Т. А., Смотрова Л. А. Рентгено-радионуклидные исследования у больных хроническим остеомиелитом . Травматология и ортопедия России. 2007; (4): 34-37
  11. Ammann P., Rizzoli R. Bone strength and its determinants. Osteoporos. Int. — 2003; 14(3): 13-18.
  12. Gulsahi A., Paksoy C. S., Yazicioglu N., Arpak N.,. Kucuk N. O, Terzioglu H. Assessment of bone density differences between conventional and bone-condensing techniques using dual energy x-ray absorptiometry and radiography. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. 2007; 104(5): 692-698.
  13. Boskey A. L., Donnelly E., Kinnett J. G. Bone quality: from bench to bedside: opening editorial comment. Clin. Orthop. Relat. Res. 2011; 469 (8): 2087-2089.
  14. Burr D. B. Bone quality: Understanding what matters.J. Musculoskel. Neuronal Interact.2004; 4( 2):184-186.
  15. Cierny G. 3rd, Di Pasquale D. Treatment of chronic infection. J. Am. Acad. Orthop. Surg.2006; 14(10):105-110.
  16. Compston J. Bone quality: what is it and how is it measured? Arq. Bras. Endocrinol. Metabol. 2006;. 50(4): 579-585.
  17. Dalle Carbonare L., Giannini S. Bone microarchitecture as an important determinant of bone strength. J. Endocrinol. Invest. 2004; 27( 1): 99-105.
  18. Guo X. E. Nanomechanics and bone tissue quality. J. Musculoskel. Neuronal Interact. 2008; 8( 4): 325-326.
  19. Hernandez C. J., Keaveny T. M. A biomechanical perspective on bone quality. Bone. 2006; 39(6): 1173-1181.
  20. Van der Linden J.C. , Verhaar J. A. N., Weinans H. J. A 3-D simulation of age-related remodeling in cancellous bone . J. Bone Miner. Res. 2001; 16( 4): 688-696



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