Postoperative bone marrow alterations: potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte scintigraphy

J E Seabold; J V Nepola; J L Marsh; D R Hawes; E P Justin; J A Ponto; W A Pettit; G Y el-Khoury; P T Kirchner

doi:10.1148/radiology.180.3.1871288

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Postoperative bone marrow alterations: potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte scintigraphy

Journal article

Peer reviewed

Postoperative bone marrow alterations: potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte scintigraphy

J E Seabold, J V Nepola, J L Marsh, D R Hawes, E P Justin, J A Ponto, W A Pettit, G Y el-Khoury and P T Kirchner

Radiology, Vol.180(3), pp.741-747

09/1991

DOI: 10.1148/radiology.180.3.1871288

PMID: 1871288

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Abstract

Scintigraphy was used after injection of technetium-99m methylene diphosphonate (MDP) and indium-111-labeled white blood cells (WBCs) to assess for the presence of osteomyelitis in 97 patients who had undergone prior surgical procedures. Thirty-four patients with abnormal In-111-labeled WBC patterns underwent restudy with Tc-99m albumin colloid (AC). Scintigraphic findings were considered positive for osteomyelitis whenever localization of In-111-labeled WBCs exceeded Tc-99m AC activity in extent or focal intensity (discordant pattern). Ten of 12 patients with culture-proved osteomyelitis had discordant patterns; two had false-negative (concordant) patterns. The cases of 20 of 22 patients without infection who were considered to have osteomyelitis on the basis of patterns of In-111-labeled WBCs and Tc-99m MDP were reclassified correctly on the basis of concordant patterns of In-111-labeled WBCs and Tc-99m AC. Radiocolloid images improved the overall scintigraphic specificity for osteomyelitis from 59% without bone marrow imaging to 92%; sensitivity decreased from 94% to 88%.

Osteomyelitis - surgery

Technetium Tc 99m Medronate

Prospective Studies

Humans

Middle Aged

Male

Leukocytes

Fractures, Ununited - complications

Osteomyelitis - etiology

Osteomyelitis - diagnostic imaging

Diagnostic Errors

Bone and Bones - diagnostic imaging

Joint Prosthesis

Sensitivity and Specificity

Adolescent

Radionuclide Imaging

Adult

Female

Aged

Bone Marrow - diagnostic imaging

Indium Radioisotopes

Details

Title: Subtitle: Postoperative bone marrow alterations: potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte scintigraphy
Creators: J E Seabold - Department of Radiology, University of Iowa College of Medicine, Iowa City 52242
J V Nepola
J L Marsh
D R Hawes
E P Justin
J A Ponto
W A Pettit
G Y el-Khoury
P T Kirchner
Resource Type: Journal article
Publication Details: Radiology, Vol.180(3), pp.741-747
Publisher: United States
DOI: 10.1148/radiology.180.3.1871288
PMID: 1871288
ISSN: 0033-8419
eISSN: 1527-1315
Language: English
Date published: 09/1991
Academic Unit: Radiology; Orthopedics and Rehabilitation; Pharmacy Practice and Science
Record Identifier: 9984040229602771

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