Bone scan: indium-WBC correlation in the diagnosis of osteomyelitis of the foot.
A retrospective study was performed of 20 podiatric cases using technetium-99m methylene diphosphonate three-phase bone scans along with indium-111 oxine leukocyte scans, as needed, to determine the presence and extent of osteomyelitis of the foot. Using criteria developed at our institution, the authors attempt to provide a mechanism to make a reliable diagnosis for osteomyelitis that has been supported by surgical/pathologic confirmation of long-term clinical follow-up. The sensitivity, using bone scans alone, was 100%, and specificity was 47%. Correlating bone and indium-111 leukocyte scans yielded a sensitivity of 100% with a specificity raised to 81%. Indium-111 leukocyte scans were used in 40% of cases when a definitive diagnosis for osteomyelitis could not be made on the basis of the three-phase bone scan or clinical presentation alone. Indium-111 leukocyte scans were also helpful in delineating the extent of the disease process. The authors present a standard technique for a 5-hour delayed imaging in the three-phase bone scan, as well as marking the foot in the indium-111 leukocyte scan with three routine views obtained for each imaging procedure, to ensure clinical accuracy.
Eisenberg
B
B
Nuclear Medicine and Podiatry Services, Veterans Administration Medical Center, Albuquerque, New Mexico 87108.
Wrege
S S
SS
Altman
M I
MI
Moore
J W
JW
D000328:Adult; D000368:Aged; D005534:Foot Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007205:Indium Radioisotopes; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012189:Retrospective Studies
D007205:Indium Radioisotopes