(PI-004) The Role of Interventional Radiology in Pediatric Wound Care

Friday, April 10, 2026

Nathan Fagan, M.D.

Introduction:

Introduction:

In the pediatric population, chronic wounds are the primary admission diagnosis for 3,015 hospitalizations per year in the United States resulting in a 75 million USD annual cost burden. Children with immobility disorders such as myelomeningocele or cerebral palsy are most at risk for chronic non-healing wounds, representing a different landscape than co-morbidities associated with the adult wound population. Our previous data demonstrates that eighty-eight percent of pediatric hospitalizations for non-healing wounds are associated with a recalcitrant bacterial biofilm-mediated infection of the bone called osteomyelitis. Osteomyelitis is the primary reason that advanced pediatric wounds do not heal when medical and social support has otherwise been optimized. Diagnosis of osteomyelitis is challenging owing to the lack of specificity conferred by MRI and the low probability of positive cultures results with bone biopsy. Image-guided biopsy offers significant advantages over traditional open surgical biopsies for the diagnosis and management of osteomyelitis in children.

Methods:

Methods: Data supporting the use of image-guided biopsy and a description of technique and wound care physician collaboration with interventional radiology are included.

Results:

Results: One of several imaging modalities can be utilized for image guidance during a biopsy. The most widely available guidance techniques include ultrasound, CT, and fluoroscopy. While all the modalities increase the likelihood of a successful biopsy by allowing for localization of the area of interest, each imaging modality has its strengths. Further, the greatest strength of image guided biopsy is offered when different modalities are used in combination in real-time. For example, ultrasound may be used to drain an associated fluid collection prior to using fluoroscopy to biopsy an area of abnormal bone for the evaluation of osteomyelitis.

Discussion:

Conclusions: By utilizing real-time imaging techniques like fluoroscopy, CT, MRI, or ultrasound, physicians can precisely target the abnormal areas within tissue. This not only leads to improved sampling, but smaller incisions, reduced risk of damage to surrounding healthy tissue, and decreased scarring. Furthermore, minimally invasive procedures often result in shorter procedure times, lower costs, and quicker recovery for patients compared to open surgical biopsies. The pediatric population benefits from these advantages, in particular.