Scintigraphy and ultrasonography in differentiating osteomyelitis from bone infarction in sickle cell disease.
OBJECTIVE
To demonstrate the combined use of scintigraphy and ultrasonography (US) in differentiating osteomyelitis from bone infarction in sickle cell disease.


METHODS
Two patients with sickle cell disease were examined with a combination of bone, bone marrow, white blood cell and/or gallium scintigraphy and US.


RESULTS
The scintigraphic studies demonstrated areas of suspected osteomyelitis at the distal femur in both patients and at the proximal right tibia in one of them. US revealed subperiosteal fluid collections in these areas. Aspiration guided by US established the presence of pus at the femur in both instances, which was successfully treated with the US-guided insertion of a drainage catheter and aspiration only, respectively. Thick blood, due to bone infarction, was aspirated at the tibia.


CONCLUSIONS
The scintigraphic studies were useful in locating all areas of suspected osteomyelitis. The role of US was to confirm the presence of a subperiosteal fluid collection and to guide aspiration, which can show the distinction between a haematoma and an abscess.
Rifai
A
A
Department of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Nyman
R
R
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000000981:diagnostic imaging*; D001853:Bone Marrow / Q000000981:diagnostic imaging; D001842:Bone and Bones / Q000098:blood supply* / Q000000981:diagnostic imaging; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005710:Gallium Radioisotopes; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D015609:Organotechnetium Compounds; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000209:etiology; D010091:Oximes; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D013669:Technetium Tc 99m Medronate; D014463:Ultrasonography
D005710:Gallium Radioisotopes; D015609:Organotechnetium Compounds; D010091:Oximes; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D013669:Technetium Tc 99m Medronate