CTICasesSternal MRSA Osteomyelitis
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Imaging findings
CT pulmonary angiogram obtained on a PE protocol shows a subtle cortical break in the anterior aspect of the sternum, associated with fatty reticulation of the overlying chest wall. Marrow attenuation within the sternum is altered, and there is mild edema and inflammatory change involving the medial fibers of the right pectoralis muscle. CT-guided aspiration of the sternal lesion confirmed MRSA osteomyelitis.
Key takeaways
Sternal osteomyelitis is a rare cause of acute chest pain that can mimic pulmonary embolism or cardiac ischemia, particularly in immunocompromised patients or those with a history of recurrent infections. When reviewing negative CT pulmonary angiograms, a thorough evaluation of the chest wall is essential to identify subtle signs of infection such as fat stranding, bone erosion, and surrounding muscular edema.
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