[Algodystrophy versus postoperative infection: use of labelled white cell scans in differential diagnosis in the hand; a case report].
The differential diagnosis between complex regional pain syndrome (CRPS) and postoperative infection is sometimes difficult. We discuss such a case following surgical release of a trigger finger. Because of lack of an accurate diagnosis, the patient was subjected to more and more costly investigations and was operated one more (and unnecessary) time. As white blood cell scintigraphy ((99m)technetium hexamethylpropyleneamineoxime leukocyte [(99m)Tc HMPAO leu]) proved negative, it allowed us to identify with high specificity, a non infectious cause for the problem, and to stop over-investigation and inflation of the costs of treatment. However, the use of white blood cell scintigraphy should remain exceptional, because of its complexity and expense.
de Soras
X
X
Groupe de chirurgie de la main et du membre supérieur, clinique Saint-Joseph, 73000 Chambéry, France. x.desoras@clinique-saint-joseph.fr
Brard
P Y
PY
D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D003937:Diagnosis, Differential; D005260:Female; D006225:Hand / Q000601:surgery*; D006801:Humans; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis* / Q000382:microbiology; D012680:Sensitivity and Specificity; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000382:microbiology; D019690:Technetium Tc 99m Exametazime; D013933:Thumb / Q000601:surgery
D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime