Abstract
Fifty-nine patients with suspected osteomyelitis were referred to the Nuclear Medicine Service for bone scanning during a twelve month period. The bone scan correctly identified abnormal sites in 18 of 19 patients with osteomyelitis (sensitivity of 95%) while the radiograph detected only 6 of 19 (sensitivity of 32%). In this clinical setting, the bone scans and radiographs had specificities of 92% and 89% respectively. Technetium-99m phosphate radiopharmaceuticals are superior to the previously used isotopes of fluorine and strontium in that they are readily available, can be imaged with conventional instruments, and allow high quality scans to be completed within 4 h. Routine bone scanning should be performed in patients presenting with suspected osteomyelitis and normal radiographs. The scan can be helpful in confirming or excluding the clinical suspicion and can lead to a more rapid institution of appropriate treatment.
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Barrett, J.J., Smith, P.H.S.: Bone imaging with 99mTc polyphosphate: a comparison with 18F and skeletal radiography. Br. J. Radiol. 47, 387–392 (1974)
Duszynski, D.O., Kuhn, J.P., Afshani, E., Riddlesberger, M.M. Jr.: Early radionuclide diagnosis of acute osteomyelitis. Radiology 117, 337–340 (1975)
Fletcher, J.W., Solaric-George, E., Henry, R.E., and Donati, R.M.: Evaluation of 99mTc-pyrophosphate as a bone imaging agent. Radiology 109, 467–468 (1973)
Garnett, E.S., Bowen, B.M., Coates, G., and Nahmias, C.: An analysis of factors which influence the local accumulation of bone-seeking radiopharmaceuticals. Invest. Radiol. 10, 564–568 (1975)
Genant, H.K., Bautovich, G.J., Singh, M., Lathrop, K.A., and Harper, P.V.: Bone-seeking radionuclides: an in vivo study of factors affecting skeletal uptake. Radiology 113, 373–382 (1974)
Hannis, N.H.: Some problems in the diagnosis and treatment of acute osteomyelitis. J. Bone Joint Surg. (Brit.) 42-B/3, 535–541 (1960)
Krishnamurthy, G.T., Walsh, C.F., Shoop, L.E., Berger, H.G., and Blahd, W.H.: Comparison of 99mTc-polyphosphate and 18F. II. Imaging. J. Nucl. Med. 15, 837–843 (1975)
Lentle, B.C., Russell, A.S., Percy, J.S., Scott, J.R., and Jackson, F.I.: Bone scintiscanning updated. Ann. Intern. Med. 84, 297–303 (1976)
McNeil, B.J., Adelstein, S.J.: Determining the value of diagnostic and screening tests. J. Nucl. Med. 17, 439–448 (1976)
Marty, R., Denney, J.D., McKamey, M.R., and Rowley, M.J.: Comparison of 85Sr, 87mSr, 18F, and 99mTc-labeled phosphates for bone scanning. CRC crit. Rev. Clin. Radiol. Nucl. Med. 6, 403–423 (1975)
Merrick, M.V.: Review article — Bone scanning. Br. J. Radiol. 48, 327–351 (1975)
Trauner, D.A. and Conner, J.D.: Radioactive scanning in diagnosis of acute sacroiliac osteomyelitis. J. Pediatr. 87, 751–753 (1975)
Treves, S., Khettry, J., Broker, F.H., Wilkinson, R.H., and Watts, H.: Early scintigraphic detection in children. Pediatrics 57, 173–186 (1976)
Waldvogel, F.A., Medoff, G., Swartz, M.N.: Osteomyelitis: A review of clinical features, therapeutic considerations, and unusual aspects (three parts). N. Engl. J. Med. 282, 198–206, 260–266, 316–322 (1970)
Waxman, A.D., Bryan, D., Siemsen, J.K.: Bone scanning in the drug abuse patient: early detection of hematogeneous osteomyelitis. J. Nucl. Med. 14, 647–650 (1973)
Weber, D.A., Keyes, J.W., Landman, S., Wilson, G.A.: Comparison of 99mTc polyphosphate and 18F for bone imaging. Am. J. Roentgenol. Radium Ther. Nucl. Med. 121, 184–190 (1974)
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Nelson, H.T., Taylor, A. Bone scanning in the diagnosis of acute osteomyelitis. Eur J Nucl Med 5, 267–269 (1980). https://doi.org/10.1007/BF00271910
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DOI: https://doi.org/10.1007/BF00271910