Diagnostic imaging: Its role in evaluating chest, abdominal, and musculoskeletal infections

Imaging studies can provide essential information when infection is suspected. Chest radiography remains the best radiographic screening tool for intrathoracic infections. Computed tomographic (CT) scanning is preferred for evaluation of solid-organ abscesses, peritoneal abscesses, and associated malignant tumors or adenopathy. Ultrasonography is used primarily in evaluation of the gallbladder, biliary system and, increasingly, the appendix. Magnetic resonance imaging is highly sensitive in detecting osteomyelitis. The whole-body screening capability of radionuclide imaging can provide unique and highly diagnostic images of suspected "occult" infection. When considered together with findings on other imaging studies and clinical examination, radionuclide scans can provide a detailed definition of a patient's infection. Although no imaging study is truly inexpensive, a well-considered imaging plan formulated in consultation with nuclear medicine specialists and radiologists can yield the most efficient use of healthcare resources.