Diagnostic Imaging

Apparently, for the first few days there’s no abnormality in the bone showed in the
plain x-ray.
By the end of second week there may be a faint extra cortical outline due to periosteal
newbone formation. Later the periosteal thickening becomes more obvious and there’s patchy
rarefaction of metaphysis.
Late sign shows combination of regional osteoporosis with localized segment of
increased density. The osteoporosis is a feature of metabolically active and indicate a living
bone; the non osteoporotic is metabolically inactive, thus possibly dead bone.
Technetium 99m bone scans can confirm yhe diagnosis as early as 24-48 hours after
onset in 90%-95% of patients. Gallium scans and indium 111 labeled leucocyte labeled can
also aid in diagnosis when used in conjuction with technetium scanning.
Magnetic Resonance Imaging (MRI) can confirmed early inflammatory changes in
bone marrow and soft tissue.