False-negative triple-phase bone scans in spinal cord injury to detect clinically suspect heterotopic ossification: a case series.
OBJECTIVE
Heterotopic ossification (HO) is a complication seen in patients after spinal cord injury (SCI). Triple-phase nuclear bone scanning is the most sensitive test for the detection of HO. This retrospective study assesses whether patients with clinically suspected HO but negative triple-phase nuclear bone scans develop delayed positive nuclear bone scans.


METHODS



METHODS
A cohort of patients with SCI and clinically suspected HO who underwent triple phase nuclear bone scans over a period of 2 years was identified from retrospective chart review of an acute inpatient SCI rehabilitation service. A subgroup of 7 patients with initially negative but subsequently positive triple-phase nuclear bone scans was identified, and the following data were collected: date, mechanism, admission level, and admission completeness of injury as well as date, number, and results of bone scans. Laboratory studies were also collected during the time of imaging.


RESULTS
Over a 2-year period, 343 patients were admitted to the SCI rehabilitation service; 60 patients were suspected of having HO and underwent a total of 85 triple-phase nuclear bone scans. Seven patients were identified with initially negative but subsequently positive bone scans.


CONCLUSIONS
In patients with clinically suspicious HO but negative bone scans, follow-up scans are indicated to identify initial false-negative studies.
Svircev
Jelena N
JN
Puget Sound VA Health Care System, Seattle, Washington, USA.
Wallbom
Agnes S
AS
D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D015331:Cohort Studies; D003951:Diagnostic Errors / Q000517:prevention & control; D005188:False Negative Reactions; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*