{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T15:04:38Z","timestamp":1777475078920,"version":"3.51.4"},"reference-count":0,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2008,10,1]],"date-time":"2008-10-01T00:00:00Z","timestamp":1222819200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2008,10]]},"abstract":"<jats:p>Background: Hematogenous osteomyelitis is often difficult to distinguish from a bone tumor because clinical findings are noncontributory and radiological features can mimic a bone tumor. Recently, the penumbra sign, a higher signal intensity feature of the thin layer of granulation tissue which lines the abscess cavity on T1-weighted magnetic resonance (MR) images, has been reported to be helpful for discriminating subacute osteomyelitis.<\/jats:p>\n                  <jats:p>Purpose: To determine helpful findings for distinguishing osteomyelitis from bone tumors.<\/jats:p>\n                  <jats:p>Material and Methods: The laboratory and imaging findings of a consecutive series of 244 patients referred to our institution with a suspected bone tumor were reviewed. There were 15 cases of osteomyelitis, 160 bone tumors, and 69 tumor-like lesions.<\/jats:p>\n                  <jats:p>Results: In osteomyelitis, the C-reactive protein (CRP) level increased in nine patients and the penumbra sign was seen in 11 patients. In bone tumors and tumor-like lesions, a high CRP level was observed in 21 patients and the penumbra sign was seen in two patients. The sensitivity of the penumbra sign for osteomyelitis was 73.3%, with a specificity of 99.1%.<\/jats:p>\n                  <jats:p>Conclusion: The penumbra sign and a high CRP level support the diagnosis of osteomyelitis and may help to exclude the presence of a tumor.<\/jats:p>","DOI":"10.1080\/02841850802241809","type":"journal-article","created":{"date-parts":[[2008,7,10]],"date-time":"2008-07-10T16:43:08Z","timestamp":1215708188000},"page":"928-933","source":"Crossref","is-referenced-by-count":53,"title":["Differential diagnosis between osteomyelitis and bone tumors"],"prefix":"10.1177","volume":"49","author":[{"given":"S.","family":"Shimose","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; Department of Orthopedic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Sugita","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; Department of Orthopedic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; Department of Orthopedic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; Department of Orthopedic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Nobuto","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; Department of Orthopedic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Ochi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; Department of Orthopedic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2008,10,1]]},"container-title":["Acta Radiologica"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/02841850802241809","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/02841850802241809","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:51:25Z","timestamp":1777384285000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1080\/02841850802241809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,10]]},"references-count":0,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2008,10]]}},"alternative-id":["10.1080\/02841850802241809"],"URL":"https:\/\/doi.org\/10.1080\/02841850802241809","relation":{},"ISSN":["0284-1851","1600-0455"],"issn-type":[{"value":"0284-1851","type":"print"},{"value":"1600-0455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,10]]}}}