Scintigraphic evaluation of extremity pain in children: its efficacy and pitfalls.
Early detection of an inflammatory process involving bone and joints is very important in children with extremity pain. We reviewed the efficacy and pitfalls of three-phase bone scans in 100 consecutive children with acute extremity pain. Sixty-one of the subjects showed abnormalities on bone scans. The sensitivity and specificity of three-phase bone scans for acute osteomyelitis were 84% and 97%, respectively. Sensitivity and specificity for both acute septic joint and cellulitis were 93% and 100%, respectively. Pitfalls in interpretation of three-phase bone scans include simulation of infection by fracture and obscuration of osteomyelitis by septic arthritis, prior antibiotic treatment, and the occasional "cold" defect due to ischemia.
D000208:Acute Disease; D000293:Adolescent; D001170:Arthritis, Infectious / Q000150:complications / Q000000981:diagnostic imaging; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002481:Cellulitis / Q000150:complications / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005121:Extremities / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010019:Osteomyelitis / Q000150:complications / Q000000981:diagnostic imaging; D010146:Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate
D013669:Technetium Tc 99m Medronate