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Ghost sign (osteomyelitis)

Last revised by Assoc Prof Frank Gaillard on 19 Apr 2021

The ghost sign is an MRI feature of osteomyelitis and is helpful in distinguishing a pure (aseptic) Charcot joint from one complicated by superimposed infection. 

Radiographic features

MRI

This sign refers to the poor definition of the margins of a bone on non-contrast T1 weighted image, blending with the surrounding inflammatory phlegmon/fluid. After contrast injection, however, the outline of the bone becomes visible once more 1.

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