Hi dr. Agten! Have you ever read this article? Predicting osteomyelitis in patients whose initial MRI demonstrated bone marrow edema without corresponding T1 signal marrow replacement . Skeletal Radiology What do you think about it? I have used this criteria once, and it was useful . By the way, your videos are amazing, cause you show us your daily basis!!
Hi Gustavo, thank you for that interesting link. That study would have benefited if they would have measured signal intensity on T1 as well. As far as I have understood it, they just "look" at T1 and if still fatty marrow, then patient was included. Well, the ratio BME/joint fluid, is kind of dependent on the signa lintensity of the bone marrow edema. So strong bone marrow edema is a predictor, now we know that strong bone marrow edema also reduces T1 signal a bit and sometimes the T1 fatt marrow is not yet fully replaced, but "partially" or the process of osteomyelitis is just starting. So I guess I am saying that if you have very strong BME, therefore higher ratio, you are more likely to develop osteomyelitis, maybe because it was already a beginning osteomyelitis? While such studies are nice, i feel they do not help in clinical practice a lot (as most research)
Thank you for this video, I'm convinced I have Tetanus that nobody can diagnose and treat here, instead I'm being told MRI shows possible bone edema and bone infection, and my Primary Doctor insisted on bone biopsy to find what is causing it because they can't determine without biopsy. I'm concerned biopsy will allow Tetanus into bone and give me bone infection claiming I already had it. I'm politically attacked by government locally for years during legalization of cannabis in Michigan while Senator Levin gave me help at times, he died in 2021 at time of my wound squirted by nurses at clinic with unknown liquid claiming it's saline that gave me Tetanus going undiagnosed now. . I need help interpreting MRI from 9-28-22 and can get another now after months of Tetanus boosters to stop toxins allowing healing, but Primary Doctor says I still need invasive biopsy to know for sure. I'm concerned they can't diagnose Tetanus to give me Tetanus Immune Globulin and instead will cause bone infection and claim I already had it, my ankles are evidence of pesticide poisoning internally that caused peripheral vascular disease for years that stabilized 10 years ago and being aggravated by pesticides in legalized store cannabis being ignored and I was trying to report to State Government. I've learned much about Tetanus I can share in exchange for helping me read MRI. Thank you!
@@user-up4zi1do6p thank you for your good advice, I agree. I insisted on a PET Scan which that hospital doesn't do, my outpatient PCP there kept avoiding PET Scan request and insisting on only another MRI or CT Scan at their hospital, we argued until my PCP discharged me from their services to find a new doctor. I changed Medicaid Insurance Plan and doctor during month of March as my one month a year window to change insurance plans, my new doctor takes effect April 1st to make appointment to be seen.
Less likely, but clinical information is very important. In the foot there is most of the time an ulcer in cases with OM (unless patient had surgery etc...)
Had a jar infection that spread to four teeth. Got them all polled and according to CT scan infection was gone but lack of bone. After an MRI from infectious disease doctor showed bone marrow Edema and I was put on vancomycin my pic line for six weeks. Still have bone marrow Edema and also bacterial arthritis from this. But new oral surgeon won’t do anything because CT scan is clear. What should I do. I believe previous tooth extraction left abscess as it was broken out instead of pulled whole. Could I possibly pay you to look at my MRI and CT scan?
Thank you for reaching out. I am not an expert in jar and teeth etc. It does not belong to the musculoskeletal system. However in my company ARISTRA we have experts in this area. Contact me via email if you are interested
Out of curiosity and my own experience recently, I'm wondering about your tetanus vaccination record and possible rare lower grade tetanus infection going misdiagnosed?
As an MS4 I thank you for posting this! So helpful!
Great for residents!
Danke für das gute Video!
Thx
Hi dr. Agten! Have you ever read this article?
Predicting osteomyelitis in patients whose initial MRI demonstrated bone marrow edema without corresponding T1 signal marrow replacement . Skeletal Radiology
What do you think about it? I have used this criteria once, and it was useful .
By the way, your videos are amazing, cause you show us your daily basis!!
Hi Gustavo, thank you for that interesting link. That study would have benefited if they would have measured signal intensity on T1 as well. As far as I have understood it, they just "look" at T1 and if still fatty marrow, then patient was included. Well, the ratio BME/joint fluid, is kind of dependent on the signa lintensity of the bone marrow edema. So strong bone marrow edema is a predictor, now we know that strong bone marrow edema also reduces T1 signal a bit and sometimes the T1 fatt marrow is not yet fully replaced, but "partially" or the process of osteomyelitis is just starting. So I guess I am saying that if you have very strong BME, therefore higher ratio, you are more likely to develop osteomyelitis, maybe because it was already a beginning osteomyelitis?
While such studies are nice, i feel they do not help in clinical practice a lot (as most research)
Good presentation 👍
Thank you 🙂
Great video!
thanks for the feedback
Hi Dr thank you so much for this Video ! Which antibiotics do you then prescribe to treat osteomyelitis? Is Ertapanem good one
Kindly reply to me I really need your response 😭😭🙏🙏
Thanks Dunya. Please consult with your doctor. I can't give medical advice over the internet like this. Thank you for your understanding.
Dr Christoph Agten thank you for your reply Dr I completely understand 🙏
Thank you for this video,
I'm convinced I have Tetanus that nobody can diagnose and treat here, instead I'm being told MRI shows possible bone edema and bone infection, and my Primary Doctor insisted on bone biopsy to find what is causing it because they can't determine without biopsy.
I'm concerned biopsy will allow Tetanus into bone and give me bone infection claiming I already had it.
I'm politically attacked by government locally for years during legalization of cannabis in Michigan while Senator Levin gave me help at times, he died in 2021 at time of my wound squirted by nurses at clinic with unknown liquid claiming it's saline that gave me Tetanus going undiagnosed now. .
I need help interpreting MRI from 9-28-22 and can get another now after months of Tetanus boosters to stop toxins allowing healing, but Primary Doctor says I still need invasive biopsy to know for sure. I'm concerned they can't diagnose Tetanus to give me Tetanus Immune Globulin and instead will cause bone infection and claim I already had it, my ankles are evidence of pesticide poisoning internally that caused peripheral vascular disease for years that stabilized 10 years ago and being aggravated by pesticides in legalized store cannabis being ignored and I was trying to report to State Government. I've learned much about Tetanus I can share in exchange for helping me read MRI.
Thank you!
Go to another hospital and get the answers you need.
@@user-up4zi1do6p thank you for your good advice, I agree. I insisted on a PET Scan which that hospital doesn't do, my outpatient PCP there kept avoiding PET Scan request and insisting on only another MRI or CT Scan at their hospital, we argued until my PCP discharged me from their services to find a new doctor. I changed Medicaid Insurance Plan and doctor during month of March as my one month a year window to change insurance plans, my new doctor takes effect April 1st to make appointment to be seen.
Thanks for the video. How about bone signal alterations without skin ulcerations? Can it still be osteomyelitis?
Less likely, but clinical information is very important. In the foot there is most of the time an ulcer in cases with OM (unless patient had surgery etc...)
Thanks, Dr Chris for the reply!
That’s what happened to me when I had it so it is possible
Had a jar infection that spread to four teeth. Got them all polled and according to CT scan infection was gone but lack of bone. After an MRI from infectious disease doctor showed bone marrow Edema and I was put on vancomycin my pic line for six weeks. Still have bone marrow Edema and also bacterial arthritis from this. But new oral surgeon won’t do anything because CT scan is clear. What should I do. I believe previous tooth extraction left abscess as it was broken out instead of pulled whole. Could I possibly pay you to look at my MRI and CT scan?
Thank you for reaching out. I am not an expert in jar and teeth etc. It does not belong to the musculoskeletal system. However in my company ARISTRA we have experts in this area. Contact me via email if you are interested
Dr Christoph Agten yes I am interested. Can I ask what your email is?
@@CountryKyle007 you find the contract in my TH-cam channel under about. Can't post it here
.else I get spammed by bots😉
Out of curiosity and my own experience recently, I'm wondering about your tetanus vaccination record and possible rare lower grade tetanus infection going misdiagnosed?
thanks a lot
Happy to help
Tnx sir
Welcome
How does the ulcer appear .it's signal char?
👌
;)
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Then consider to become a patreon at patreon.com/agten 😛