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Diagnosis of infection in ununited fractures : combined imaging with indium-111-labeled leukocytes and technetium-99m methylene diphosphonate
Journal article   Peer reviewed

Diagnosis of infection in ununited fractures : combined imaging with indium-111-labeled leukocytes and technetium-99m methylene diphosphonate

J. V NEPOLA, J. E SEABOLD, J. L MARSH, P. T KIRCHNER and G. Y EL-KHOURY
Journal of bone and joint surgery. American volume, Vol.75(12), pp.1816-1822
1993
DOI: 10.2106/00004623-199312000-00012
PMID: 8258553

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Abstract

The results of combined scintigraphy in which indium-111-labeled leukocytes and technetium-99m methylene diphosphonate were used were compared with the results of cultures of open bone at 102 sites of delayed union or non-union, to determine the effectiveness of this combination as a preoperative indicator of osteomyelitis. There were twenty-five true-positive, fifty-nine true-negative, eleven false-positive, four false-negative, and three indeterminate interpretations, yielding, for the diagnosis of osteomyelitis, a sensitivity of 86 per cent, a specificity of 84 per cent, an accuracy of 82 per cent, a positive predictive value of 69 per cent, and a negative predictive value of 94 per cent. There were few false-negative scans; false-positive results were most likely at a metaphyseal site adjacent to a joint in which there was post-traumatic arthropathy, at the site of a failed arthrodesis, and at the site of an unstable delayed union or non-union.
 Osteoarticular system. Muscles Biological and medical sciences Radionuclide investigations Investigative techniques, diagnostic techniques (general aspects) Medical sciences

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