title: Evaluation of complicating osteomyelitis with Tc-99m MDP, In-111 granulocytes, and Ga-67 citrate.
abstract: Studies with gallium-67 and three-phase bone imaging (TPBS), though very sensitive, are not very specific in evaluating suspected osteomyelitis (OM) that is superimposed upon other diseases causing increased bone turnover. A total of 57 patients with suspected OM were studied; this included 48 with increased bone turnover. All of the patients were studied with granulocytes labeled with In-111 acetylacetone (In-111 GRAN), TPBS and 29 of these patients had Ga-67 studies as well. In-111 GRAN had a sensitivity of 100% in acute OM and 60% in chronic OM, with a specificity of 96%. Gallium-67 was excellent in ruling out OM when the study was normal, or in ruling in OM when the relative uptake of Ga-67 exceeded the uptake of Tc-99m MDP, or when the Ga-67 in bone had a different distribution from the TPBS. Unfortunately, these criteria were met in only 28% of our subjects. We conclude that when added to TPBS, the In-111 GRAN study plays an important role in detecting complicating OM.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000150:complications; D001842:Bone and Bones / Q000601:surgery; D002908:Chronic Disease; D004164:Diphosphonates; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D005710:Gallium Radioisotopes; D006098:Granulocytes; D006801:Humans; D007204:Indium; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications / Q000000981:diagnostic imaging*; D019736:Prostheses and Implants; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013667:Technetium; D013669:Technetium Tc 99m Medronate
chemical_list: D004164:Diphosphonates; D005710:Gallium Radioisotopes; D011868:Radioisotopes; D007204:Indium; D013667:Technetium; D013669:Technetium Tc 99m Medronate