Detection of acute osteomyelitis with indium-111 labeled white blood cells in a patient with sickle cell disease.
A young patient with sickle cell disease (SCD) and multiple hospitalizations for crisis was admitted because of suspected osteomyelitis. Initial laboratory work, radiographs, and bone images were not contributory. An In-111 white blood cell (WBC) study demonstrated two areas of increased radionuclide uptake consistent with osteomyelitis. One of these had associated soft tissue infection. No other areas of active osteomyelitis were visualized, in spite of the presence of several additional infection sites. Imaging with In-111 WBC is probably not justified for routine diagnosis of acute osteomyelitis in areas free of previous disease, where conventional bone images are highly efficient. In-111 WBC imaging, however, may be helpful in detecting osteomyelitis in selected patients with SCD in whom Tc-99m bone images and radiographs are usually abnormal and difficult to interpret due to previous bone infarcts. Localization of the infection focus is very important in choosing the aspiration site for bacteriologic studies. A negative study, however, should be interpreted cautiously.
Fernandez-Ulloa
M
M
Eugene L. Saenger Radioisotope Laboratory, University of Cincinnati Medical Center, Ohio 45267-0577.
Vasavada
P J
PJ
Black
R R
RR
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications / Q000000981:diagnostic imaging*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D006801:Humans; D007205:Indium Radioisotopes; D007962:Leukocytes; D010019:Osteomyelitis / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging
D007205:Indium Radioisotopes