title: Bone infection in patients suspected of complicating osteomyelitis: the diagnostic value of dual isotope bone-granulocyte scintigraphy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the diagnostic value of dual isotope bone-granulocyte scintigraphy in patients with known bone pathology clinically suspected of osteomyelitis, i.e. complicating osteomyelitis, using per-operative bacterial culture from bone as reference.
  
  
  METHODS
  Simultaneous dual isotope bone-granulocyte scintigraphic images were obtained in 42 consecutive patients in whom conventional X-ray, erythrocyte sedimentation rate, and C-reactive protein were also available. 99mTc MDP bone and 111In labelled granulocyte imaging was obtained simultaneously. The images were interpreted as positive for osteomyelitis if regions of interests of pathologic 111In granulocyte accumulation included 99mTc MDP activity on the bone images (except in the spine).
  
  
  RESULTS
  The sensitivity, specificity, and accuracy were 84, 71 and 79%, respectively, for simultaneous, dual isotope bone-granulocyte scintigraphy, higher than the other diagnostic parameters.
  
  
  CONCLUSIONS
  Simultaneous bone-granulocyte scintigraphy is a valuable diagnostic tool in diagnosing osteomyelitis complicating other bone pathology with or without soft-tissue infection.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, University Hospital, Copenhagen, Denmark. t.buhl@rh.dk
authors.forename: Thora
authors.initials: T
authors.lastname: Buhl
authors.forename: Kim
authors.initials: K
authors.lastname: Stentzer
authors.forename: Adam
authors.initials: A
authors.lastname: Hede
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjaer
authors.forename: Birger
authors.initials: B
authors.lastname: Hesse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006098:Granulocytes / Q000000981:diagnostic imaging* / Q000382:microbiology; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D011237:Predictive Value of Tests; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m
chemical_list: D007205:Indium Radioisotopes; D019275:Radiopharmaceuticals; D002097:C-Reactive Protein; D013670:Sodium Pertechnetate Tc 99m