[FDG-PET for diagnosis and follow-up of inflammatory processes: initial results from the orthopedic viewpoint].
OBJECTIVE
The diagnosis and the assessment of osteomyelitis and spondylodiscitis can be difficult. The aim of this study was to evaluate the usefulness of FGD-PET in the detection of inflammatory processes.


METHODS
23 orthopedic patients suspected of having peripheral osteomyelitis (n = 13) or spondylodiscitis (n = 10) were examined consecutively with FDG-PET. The FDG-PET scans were evaluated by the nuclear physicians in ignorance of the clinical diagnosis by visual interpretation, which was graded on a five-point scale (0 = no infection-4 = definitely infection).


RESULTS
Of 23 patients, 15 had osteomyelitis (n = 8) or spondylodiscitis (n = 7). In these 15 cases, the FDG-PET was true-positive. The sensitivity was 100%. In the 8 cases without infection, the FDG-PET was in 5 cases true-negative and in 3 cases false-positive. Even with inlying metal implants, soft-tissue abscesses could be differentiated from the bony process.


CONCLUSIONS
The FDG-PET is a very sensitive procedure for the diagnosis of osteomyelitis and spondylodiscitis and for screening of inflammation foci. A further advantage is the high spatial solution. The quantification of the inflammatory activity allowed a monitoring of the therapy.
Schmitz
A
A
Klinik und Poliklinik für Orthopädie, Rhein.-Fried.-Wilh.-Universität, Bonn.
Risse
H J
HJ
Kälicke
T
T
Grünwald
F
F
Schmitt
O
O
D000038:Abscess / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D015299:Discitis / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000601:surgery; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000601:surgery; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000601:surgery; D014055:Tomography, Emission-Computed
D019788:Fluorodeoxyglucose F18