Cost effectiveness of magnetic resonance imaging in diagnosing Pseudomonas aeruginosa infection after puncture wound.

Abstract

This study was performed to determine the cost effectiveness of radiologic imaging studies in diagnosing Pseudomonas aeruginosa infections after puncture wounds and the respective comparison of imaging and scintigraphy. Using retrospective medical record review, we studied 12 patients with culture-proven Pseudomonas infections of bone, cartilage or joint, or soft tissues. Attention was paid to radiographic presentation, scintigraphic studies, and magnetic resonance imaging results. All available imaging studies were reviewed. A survey of the costs of each imaging study was conducted. All patients underwent surgery. Three patients had magnetic resonance imaging studies that provided definitive diagnosis of osteomyelitis and precise localization of involved bones, soft tissue edema, and periosteal abscess. Eight patients had bone scans, one of which was consistent with cellulitis; seven, with osteomyelitis; and two with no abnormalities. All patients had radiographs of the involved foot. Case 4 had three series of radiographs. Nine of the twelve patients (75%) had normal findings on radiographs, with only soft tissue swelling or osteoporosis. Five patients had evidence of osteomyelitis. Magnetic resonance imaging is a cost-effective method in diagnosing Pseudomonas osteomyelitis. Early use of magnetic resonance imaging can provide definitive diagnosis and more precise anatomic localization necessary for surgical intervention.