99Tcm-HMPAO-labelled leucocyte scintigraphy in suspected chronic osteomyelitis related to an orthopaedic device: clinical usefulness.
Thirty-five patients with suspected chronic osteomyelitis related to an orthopaedic device had 50 99Tcm-HMPAO-labelled leucocyte scans (LS). The scan appearances were compared with the bacteriological or clinical results and gave a sensitivity and specificity of HMPAO-LS of 83 and 100%, respectively. Bacteriological examination is often inaccurate in the diagnosis of osteomyelitis and therefore we assessed the clinical utility of HMPAO-LS. When the clinical, biological and radiological data were clearly suggestive of osteomyelitis (16/50) LS was unhelpful or even misleading when falsely negative (3/16). When the clinical, biological and radiological data were poorly suggestive of osteomyelitis (20/50) or conflicting (14/50) LS was misleading in only one patient (false negative). It is concluded that HMPAO-LS should only be performed to assist in the diagnosis of chronic osteomyelitis when there is no preexisting strong suspicion based on clinical, biological and radiological signs.
el Esper
I
I
Department of Nuclear Medicine, CHU Amiens, France.
Dacquet
V
V
Paillard
J
J
Bascoulergue
G
G
Tahon
M M
MM
Fonroget
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D002908:Chronic Disease; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D009983:Orthopedic Equipment / Q000009:adverse effects*; D009984:Orthopedic Fixation Devices / Q000009:adverse effects; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D010091:Oximes; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime