Periarticular bone sites associated with traumatic injury: false-positive findings with In-111-labeled white blood cell and Tc-99m MDP scintigraphy

James E Seabold; Randolph J Ferlic; J Lawrence Marsh; James V Nepola

doi:10.1148/radiology.186.3.8430197

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Periarticular bone sites associated with traumatic injury: false-positive findings with In-111-labeled white blood cell and Tc-99m MDP scintigraphy

Journal article

Peer reviewed

Periarticular bone sites associated with traumatic injury: false-positive findings with In-111-labeled white blood cell and Tc-99m MDP scintigraphy

James E Seabold, Randolph J Ferlic, J Lawrence Marsh and James V Nepola

Radiology, Vol.186(3), pp.845-849

03/1993

DOI: 10.1148/radiology.186.3.8430197

PMID: 8430197

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Abstract

The authors evaluate the reliability of combined indium-111-labeled white blood cell (WBC) and technetium-99m methylene diphosphonate (MDP) bone scan interpretations at sites of suspected periarticular osteomyelitis with radiographic evidence of adjacent traumatic arthropathy. A review of all orthopedic patients who underwent In-111 WBC-Tc-99m MDP scintigraphy over a 7-year period revealed a subset of 32 such cases that also included results of bone-biopsy cultures. Twenty-eight patients had a history of traumatic intraarticular injury, and four had periarticular fracture malunion or nonunion. Compared with intraoperative culture results, blinded In-111 WBC-Tc-99m MDP scan interpretations included four true-positive, 17 true-negative, and 10 false-positive results, and one false-negative result. The predictive values for positive and negative scans were 28% and 94%, respectively. A high prevalence of false-positive In-111 WBC-Tc-99m MDP scans may occur at periarticular sites of patients with associated traumatic arthropathy. This reduces the specificity of this technique for osteomyelitis, making culture confirmation of positive scans necessary. A negative scan is highly predictive of negative culture results at these sites.

Predictive Value of Tests

Technetium Tc 99m Medronate

Humans

Middle Aged

Male

Leukocytes

Osteomyelitis - complications

False Positive Reactions

Joints - injuries

Fractures, Ununited - complications

Osteomyelitis - diagnostic imaging

Bone and Bones - diagnostic imaging

Sensitivity and Specificity

Fractures, Bone - complications

Radionuclide Imaging

Adult

Female

Aged

Retrospective Studies

Osteomyelitis - epidemiology

Indium Radioisotopes

Details

Title: Subtitle: Periarticular bone sites associated with traumatic injury: false-positive findings with In-111-labeled white blood cell and Tc-99m MDP scintigraphy
Creators: James E Seabold - Department of Radiology, University of Iowa College of Medicine, Iowa City
Randolph J Ferlic
J Lawrence Marsh
James V Nepola
Resource Type: Journal article
Publication Details: Radiology, Vol.186(3), pp.845-849
Publisher: United States
DOI: 10.1148/radiology.186.3.8430197
PMID: 8430197
ISSN: 0033-8419
eISSN: 1527-1315
Language: English
Date published: 03/1993
Academic Unit: Radiology; Orthopedics and Rehabilitation
Record Identifier: 9984040572402771

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