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Diagnosis of peripheral bone and prosthetic joint infections: overview on the consensus documents by the EANM, EBJIS, and ESR (with ESCMID endorsement).

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Title: Diagnosis of peripheral bone and prosthetic joint infections: overview on the consensus documents by the EANM, EBJIS, and ESR (with ESCMID endorsement).
Authors: Sconfienza, Luca Maria1,2 (AUTHOR) io@lucasconfienza.it, Signore, Alberto3 (AUTHOR), Cassar-Pullicino, Victor4 (AUTHOR), Cataldo, Maria Adriana5 (AUTHOR), Gheysens, Olivier6 (AUTHOR), Borens, Olivier7 (AUTHOR), Trampuz, Andrej8 (AUTHOR), Wörtler, Klaus9 (AUTHOR), Petrosillo, Nicola5 (AUTHOR), Winkler, Heinz10 (AUTHOR), Vanhoenacker, Filip M. H. M.11,12,13 (AUTHOR), Jutte, Paul C.14 (AUTHOR), Glaudemans, Andor W. J. M.15 (AUTHOR)
Source: European Radiology. Dec2019, Vol. 29 Issue 12, p6425-6438. 14p. 2 Diagrams, 2 Charts.
Subjects: Joint infections, Artificial joints, Nuclear medicine, Medical microbiology, Magnetic resonance imaging, Leukocytes, Musculoskeletal system, Consensus (Social sciences), Prosthesis-related infections, Bone diseases, Medical societies, Radionuclide imaging
Geographic Terms: Europe
Abstract: Objectives: Peripheral bone infection (PBI) and prosthetic joint infection (PJI) are two different infectious conditions of the musculoskeletal system. They have in common to be quite challenging to be diagnosed and no clear diagnostic flowchart has been established. Thus, a conjoined initiative on these two topics has been initiated by the European Society of Radiology (ESR), the European Association of Nuclear Medicine (EANM), the European Bone and Joint Infection Society (EBJIS), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). The purpose of this work is to provide an overview on the two consensus documents on PBI and PJI that originated by the conjoined work of the ESR, EANM, and EBJIS (with ESCMID endorsement).Methods and Results: After literature search, a list of 18 statements for PBI and 25 statements for PJI were drafted in consensus on the most debated diagnostic challenges on these two topics, with emphasis on imaging.Conclusions: Overall, white blood cell scintigraphy and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities for the diagnosis of PBI and PJI. However, the choice of which advanced diagnostic modality to use first depends on several factors, such as the benefit for the patient, local experience of imaging specialists, costs, and availability. Since robust, comparative studies among most tests do not exist, the proposed flowcharts are based not only on existing literature but also on the opinion of multiple experts involved on these topics.Key Points: • For peripheral bone infection and prosthetic joint infection, white blood cell and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities. • Two evidence- and expert-based diagnostic flowcharts involving variable combination of laboratory tests, biopsy methods, and radiological and nuclear medicine imaging modalities are proposed by a multi-society expert panel. • Clinical application of these flowcharts depends on several factors, such as the benefit for the patient, local experience, costs, and availability. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Diagnosis of peripheral bone and prosthetic joint infections: overview on the consensus documents by the EANM, EBJIS, and ESR (with ESCMID endorsement).
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  Data: <searchLink fieldCode="AR" term="%22Sconfienza%2C+Luca+Maria%22">Sconfienza, Luca Maria</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<i> io@lucasconfienza.it</i><br /><searchLink fieldCode="AR" term="%22Signore%2C+Alberto%22">Signore, Alberto</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cassar-Pullicino%2C+Victor%22">Cassar-Pullicino, Victor</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cataldo%2C+Maria+Adriana%22">Cataldo, Maria Adriana</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gheysens%2C+Olivier%22">Gheysens, Olivier</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Borens%2C+Olivier%22">Borens, Olivier</searchLink><relatesTo>7</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Trampuz%2C+Andrej%22">Trampuz, Andrej</searchLink><relatesTo>8</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wörtler%2C+Klaus%22">Wörtler, Klaus</searchLink><relatesTo>9</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Petrosillo%2C+Nicola%22">Petrosillo, Nicola</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Winkler%2C+Heinz%22">Winkler, Heinz</searchLink><relatesTo>10</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Vanhoenacker%2C+Filip+M%2E+H%2E+M%2E%22">Vanhoenacker, Filip M. H. M.</searchLink><relatesTo>11,12,13</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jutte%2C+Paul+C%2E%22">Jutte, Paul C.</searchLink><relatesTo>14</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Glaudemans%2C+Andor+W%2E+J%2E+M%2E%22">Glaudemans, Andor W. J. M.</searchLink><relatesTo>15</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Dec2019, Vol. 29 Issue 12, p6425-6438. 14p. 2 Diagrams, 2 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Joint+infections%22">Joint infections</searchLink><br /><searchLink fieldCode="DE" term="%22Artificial+joints%22">Artificial joints</searchLink><br /><searchLink fieldCode="DE" term="%22Nuclear+medicine%22">Nuclear medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+microbiology%22">Medical microbiology</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Leukocytes%22">Leukocytes</searchLink><br /><searchLink fieldCode="DE" term="%22Musculoskeletal+system%22">Musculoskeletal system</searchLink><br /><searchLink fieldCode="DE" term="%22Consensus+%28Social+sciences%29%22">Consensus (Social sciences)</searchLink><br /><searchLink fieldCode="DE" term="%22Prosthesis-related+infections%22">Prosthesis-related infections</searchLink><br /><searchLink fieldCode="DE" term="%22Bone+diseases%22">Bone diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+societies%22">Medical societies</searchLink><br /><searchLink fieldCode="DE" term="%22Radionuclide+imaging%22">Radionuclide imaging</searchLink>
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– Name: Abstract
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  Data: <bold>Objectives: </bold>Peripheral bone infection (PBI) and prosthetic joint infection (PJI) are two different infectious conditions of the musculoskeletal system. They have in common to be quite challenging to be diagnosed and no clear diagnostic flowchart has been established. Thus, a conjoined initiative on these two topics has been initiated by the European Society of Radiology (ESR), the European Association of Nuclear Medicine (EANM), the European Bone and Joint Infection Society (EBJIS), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). The purpose of this work is to provide an overview on the two consensus documents on PBI and PJI that originated by the conjoined work of the ESR, EANM, and EBJIS (with ESCMID endorsement).<bold>Methods and Results: </bold>After literature search, a list of 18 statements for PBI and 25 statements for PJI were drafted in consensus on the most debated diagnostic challenges on these two topics, with emphasis on imaging.<bold>Conclusions: </bold>Overall, white blood cell scintigraphy and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities for the diagnosis of PBI and PJI. However, the choice of which advanced diagnostic modality to use first depends on several factors, such as the benefit for the patient, local experience of imaging specialists, costs, and availability. Since robust, comparative studies among most tests do not exist, the proposed flowcharts are based not only on existing literature but also on the opinion of multiple experts involved on these topics.<bold>Key Points: </bold>• For peripheral bone infection and prosthetic joint infection, white blood cell and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities. • Two evidence- and expert-based diagnostic flowcharts involving variable combination of laboratory tests, biopsy methods, and radiological and nuclear medicine imaging modalities are proposed by a multi-society expert panel. • Clinical application of these flowcharts depends on several factors, such as the benefit for the patient, local experience, costs, and availability. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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