title: Cold bone defect on granulocytes labelled with technetium-99m-HMPAO scintigraphy: significance and usefulness for diagnosis and follow-up of osteoarticular infections.
abstract: We wished to determine the frequency and significance of cold bone defect on granulocytes labelled with technetium-99-m-hexamethylpropyleneamine oxime (99mTc-HMPAO-PMN) in non-spinal bone infection. Cold bone defect was investigated as part of a retrospective review during a 2-y period. Patients who had possible osteoarticular infection underwent bone scintigraphy combined with 99mTc-HMPAO-PMN for diagnosis and follow-up. Osteomyelitis was confirmed by isolation of the responsible pathogen. Among 210 patients who had possible infection, 17 (8%) demonstrated a cold bone defect. The site of cold bone defect was for all patients the hip. All 17 patients had proven bacterial orthopaedic hardware-related infection. The single causative micro-organism was staphylococcus. Whatever the outcome, cold bone defect was constant regardless of follow-up equal to or longer than 18 months. These data suggest that this uncommon scintigraphic pattern is an indication of an infectious process similar to increased uptake.
authors.affiliation: Federation of Infectious Diseases, Pellegrin University Hospital, Bordeaux, France. t.galperine@rpc.ap-hop-paris.fr
authors.forename: T
authors.initials: T
authors.lastname: Galpérine
authors.forename: H
authors.initials: H
authors.lastname: Dutronc
authors.forename: S
authors.initials: S
authors.lastname: Lafarie
authors.forename: D
authors.initials: D
authors.lastname: Neau
authors.forename: B
authors.initials: B
authors.lastname: Mérino
authors.forename: G
authors.initials: G
authors.lastname: Cipriano
authors.forename: J M
authors.initials: JM
authors.lastname: Ragnaud
authors.forename: P
authors.initials: P
authors.lastname: Fernandez
authors.forename: B
authors.initials: B
authors.lastname: Basse-Cathalinat
authors.forename: M
authors.initials: M
authors.lastname: Dupon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016918:Arthritis, Reactive / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006098:Granulocytes; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate; D019690:Technetium Tc 99m Exametazime; D016896:Treatment Outcome
chemical_list: D019690:Technetium Tc 99m Exametazime