Femoral acute Osteomyelitis

         

 

 

   Male, 13 year old, with fever for about a week. Pain in the right knee, was hospitalized. Blood culture was positive for staphilococcus aureus. A bone scan was requested. It was done using 99m-Tc MDP, 15 mCi. Shown are only views from both knees, the rest of the skeleton had normal distribution of 99mTc-MDP. Arterial and pool vascular images showed  increase flow in the distal right femu. The bone phase depicted marked increased tracer accumulation in the distal femur metaphysis (arrows).

            Palestro CJ et al, discusses the role of bone scan in musculoskeletal infections and comment that "Three-phase bone imaging, readily available and relatively inexpensive, is very accurate in unviolated bone. In the setting of underlying osseous abnormalities,  however, the specificity of the test decreases. Four-phase bone, sequential bone/gallium, and labeled leukocyte imaging all have been used in an effort to enhance specificity."

        Coll C et al concluded after evaluating 38 patients that "Three-phase bone imaging is a helpful tool in the diagnosis and assessment of acute osteomyelitis in pediatric population. A positive Three-phase bone scan is highly accurate for acute osteomyelitis and a negative one rules it out securely

References:

1.- Palestro CJ, Love C. Radionuclide imaging of musculoskeletal infection: conventional agents. Semin Musculoskelet Radiol. 2007 Dec;11(4):335-52.

2.- COLL C, Claudia; CIFRAS, José Luis; MASSARDO V, Teresa y MOYA S, Hernán.CINTIGRAFIA OSEA TRIFASICA CON Tc-99m MDP EN EL DIAGNOSTICO Y MANEJO DE INFECCIONES OSTEOARTICULARES AGUDAS EN NIÑOS . Rev. chil. radiol. 2002, vol.8, n.2, pp. 83-88.

 

                  Home      Index       Clinical Applications       Clinical Applications Infections    Osteomyelitis