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Research progress on the value of MRI imaging features in the differential diagnosis of hematogenous osteomyelitis and malignant bone tumors of the extremities
CHEN Gang  LIU Yuke  ZHANG Binqing  ZHANG Yuanyuan 

DOI:10.12015/issn.1674-8034.2026.02.030.


[Abstract] The differential diagnosis of hematogenous osteomyelitis of the limbs and bone malignant tumors is a difficult clinical problem. Especially in the early stages of the disease, due to the absence of bone destruction and insignificant changes in bone structure and density, the sensitivity and specificity of X-ray and CT diagnoses are poor, leading to easy missed and misdiagnoses. MRI, with its advantages of high soft tissue resolution, sensitivity to changes in the water-lipid microenvironment, and multi-sequence, multi-parameter imaging, has been widely used in the diagnosis and differential diagnosis of osteomyelitis and bone malignant tumors. Its sensitivity and specificity for the early diagnosis of both are higher than those of X-ray and CT. Currently, research on the differential diagnosis of hematogenous osteomyelitis of the limbs and bone malignant tumors focuses on the comparison of conventional X-ray, CT, and MRI sequences, mostly describing the imaging manifestations in the late stages of the disease. There is insufficient research on the early MRI imaging features of osteomyelitis and the quantitative diagnosis using MRI functional sequences. Therefore, this paper reviews the research progress of MRI imaging features in the differential diagnosis of early-stage hematogenous osteomyelitis and malignant bone tumors of the extremities, points out the current limitations of research, and proposes future research directions, in order to provide evidence-based basis and decision support for early and accurate clinical diagnosis.
[Keywords] osteomyelitis；malignant bone tumors；osteosarcoma；magnetic resonance imaging；apparent diffusion coefficient；differential diagnosis

CHEN Gang1, 2   LIU Yuke2*   ZHANG Binqing2   ZHANG Yuanyuan2  

1 The Third Clinical College, Henan University of Chinese Medicine, Zhengzhou 450046, China

2 Medical Imaging Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province, Luoyang 471002, China

Corresponding author: LIU Y K, E-mail: yukeliu1975@163.com

Conflicts of interest   None.

Received  2025-11-13
Accepted  2026-01-28
DOI: 10.12015/issn.1674-8034.2026.02.030
DOI:10.12015/issn.1674-8034.2026.02.030.

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