Utility of three-phase skeletal scintigraphy in suspected osteomyelitis: concise communication.
Three-phase skeletal scintigraphy, consisting of a radionuclide angiogram, an immediate postinjection "blood-pool" image, and 2--3 hr delayed images, was performed on 98 patients with suspected osteomyelitis. This procedure was evaluated by first interpreting only the delayed images, next the combination of "blood-pool" and delayed images, and finally the three-phase study. There was no change in the sensitivity (12/13 = 0.92) for detecting osteomyelitis, but the false-positive rate for osteomyelitis decreased from 0.25 (21/85) to 0.06 (5/85). In 21 of 64 patients (33%) with abnormal studies, the "blood-pool" image and/or the radionuclide angiogram led to a more accurate scintigraphic diagnosis. In 12 patients (19%) the "blood pool" alone was enough to achieve the correct final diagnosis and was used most often to identify noninfectious skeletal disease. In 9 patients (14%) the radionuclide angiogram was required for an accurate interpretation and was considered essential most often in cases of soft-tissue infection. Both radionuclide angiography and "blood-pool" imaging appear to augment the specificity of skeletal scintigraphy in patients with suspected osteomyelitis.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging; D001842:Bone and Bones / Q000098:blood supply; D002481:Cellulitis / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D004164:Diphosphonates; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008722:Methods; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013667:Technetium; D013669:Technetium Tc 99m Medronate
D004164:Diphosphonates; D013667:Technetium; D013669:Technetium Tc 99m Medronate