Musculoskeletal Infections: Clinical Diagnosis and Treatment

Dear Colleagues,

The interest in the diagnosis and treatment of musculoskeletal infections has grown in recent decades, requiring a multidisciplinary approach. On the one hand, unusual pathogens appear to affect the musculoskeletal tissues, and on the other hand, common pathogens have become difficult to eradicate because of antimicrobial resistance development from extensive antibiotic use. Furthermore, a growing number of patients undergoing orthopedic procedures for trauma, degenerative, and other disorders receive orthopedic implants. Surgical site infection following orthopedic surgery with instrumentation is a serious and relatively common complication, which potentially compromises surgical outcomes and increases the overall morbidity and mortality. In addition, musculoskeletal infections have increased due to the fact that many patients undergo image-guided diagnostic and therapeutic procedures and that an increasing number of patients are immunocompromised and thus vulnerable to severe and atypical infections. Iatrogenic infections often result in prolonged hospital stays, readmissions, reoperations, and long-term intravenous antibiotics and significantly increase the cost of care.

The choice of appropriate treatment is often complex and involves the consideration of multiple factors, such as soft-tissue and implant conditions, the duration and severity of the infection, the underlying pathogen, and the patient’s morbidity and functional status.

The early involvement of multidisciplinary teams, analogous to oncological boards, consisting of radiologists, infectious diseases specialists, and orthopedic surgeons, is important to achieve the optimal result for the patient. The evolution of imaging modalities, such as high-field MRI and newer CT scanners with metal artifact reduction techniques, advanced image analysis based on radiomics, and deep learning as well as newer tracers with PET/CT, provide valuable diagnostic capabilities, which have modified the conventional diagnostic algorithm.

This Special Issue invites the participation of specialists from different scientific fields including infectious diseases, orthopedic surgery, rheumatology, and radiology.

Topics such as the diagnosis and treatment of primary bone and joint infection in children and adults and the diagnosis and treatment as well as the preventive measures of prosthetic joint infections are within the scope of this Special Issue. Studies focusing on infections caused by uncommon and difficult-to-treat pathogens such as mycobacterial or fungal infections, spinal infections, and infections related to polytrauma patients are also welcome. Finally, we are interested in imaging studies.

As editors of this Special Issue, we hope to provide a scientific overview of radiological, clinical, surgical, and epidemiological contributions, describing recent advances that can lead to improvements in diagnosis, treatment, and prognosis in the field of musculoskeletal infections.

Dr. Kalliopi Alpantaki
Prof. Dr. Apostolos Karantanas
Guest Editors

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• computed tomography
• magnetic resonance
• musculoskeletal infections
• septic arthritis
• osteomyelitis
• fungal infections
• mycobacterium infections
• prosthetic joint infections
• postoperative infections
• surgical treatment
• VAC
• hyperbaric oxygen