[Evaluation of inflammatory activity in chronic osteomyelitis. Contribution of scintigraphy with polyclonal antibodies].
BACKGROUND
Active chronic osteomyelitis or complicating osteomyelitis are difficult to be diagnosed by radiological imaging modalities, such as plain radiograph and CT. They frequently cause increased bone remodeling, leading to nonspecific uptake of Tc-99m-bone scan agents and gallium-67. New radiopharmaceuticals with greater infection avidity are being developed, including the nonspecific polyclonal immunoglobulin (IgG) labeled with technetium-99m. Tc-99m-IgG may be available as a ready to use kit, with no reported side effects, low patient absorbed radiation dose and low cost.


METHODS
23 bone segments with suspected active chronic osteomyelitis or violated bone osteomyelitis were studied by Tc-99m-IgG scintigraphy. All patients underwent standard three-phase bone scintigraphy using methylene diphosphonate (Tc-99m-MDP), gallium-67 scintigraphy and plain radiographs, compared with clinical evaluation and laboratory tests values.


RESULTS
Infection was found in 8 sites. Sensitivity and specificity for Tc-99m-MDP, gallium-67 and Tc-99m-IgG scintigraphy were, respectively, 88 and 36%, 75 and 73%, 88 and 82%.


CONCLUSIONS
Tc-99m-IgG may be usefull in the scintigraphic evaluation of osteomyelitis.
Sapienza
M T
MT
Departamento de Radiologia da Faculdade de Medicina, Universidade de São Paulo.
Hironaka
F
F
Lima
A L
AL
Yamaga
L Y
LY
Hamada
E
E
Watanabe
T
T
Costa
P A
PA
Buchpiguel
C A
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies; D001424:Bacterial Infections / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013667:Technetium
D000906:Antibodies; D013667:Technetium