MRI for the Diagnosis of Foot Osteomyelitis

In a meta-analysis of 16 studies, magnetic resonance imaging was compared with technetium bone scan (7 studies), plain x-ray (9 studies), and a white blood cell scan (WBC; 3 studies) for the diagnosis of foot osteomyelitis. In each study, bone biopsy was performed to confirm or exclude the presence of osteomyelitis.

Although there was a great deal of variability across studies, the sensitivities and specificities were higher for MRI than for the other methods. The mean sensitivity and specificity for MRI was 94% and 81% respectively; for technetium, 87% and 43%; for plain x-ray, 58% and 77%; and for WBC scans, 67% and 61%.