title: [Sensitivity and specificity of the Tc-99m ciprofloxacin scan in pediatric osteomyelitis].
abstract: BACKGROUND
  The Tc-99m-ciprofloxacin complex, introduced in 1993, has been extensively evaluated all over the world with good results for the diagnosis of active bacterial osteoarticular infections. There are only a few publications on the use of this procedure in pediatric ages. In our study we evaluated the efficacy of the Tc-99m ciprofloxacin scan for the diagnosis of osteoarticular infections in the pediatric population assessing its sensitivity, specificity, and positive and negative predictive value.
  
  
  METHODS
  A retrospective, descriptive, observational study was done in 94 patients with clinical suspicion of osteoarticular infection in whom a Tc-99m ciprofloxacin bone scan was performed; the diagnosis was confirmed with intraoperative cultures and blood cultures. The results obtained with the Tc-99m ciprofloxacin scan and the culture reports were analyzed, as well as the sensitivity, specificity and the positive and negative predictive values of the Tc-99m ciprofloxacin scan.
  
  
  RESULTS
  Among the patients with intraoperative and blood cultures, 80 cases (85.1%) were positive and 14 cases (14.9%) were negative for bone infection. In the Tc-99m ciprofloxacin scan 78 cases (83%) were found to be positive for infection and 16 cases (17%) were negative. There were two false negatives. We found a 97.6% sensitivity and 100% specificity, with a 100% positive predictive value and an 87.5% negative predictive value.
  
  
  CONCLUSIONS
  The Tc-99m-ciprofloxacin complex is useful to make the differential diagnosis between inflammation and infection in pediatric patients in whom an osteoarticular infectious process is suspected.
authors.affiliation: Instituto Nacional de Pediatría. drmoraortoped@hotmail.com
authors.forename: Félix Gustavo
authors.initials: FG
authors.lastname: Mora Ríos
authors.forename: Agustín
authors.initials: A
authors.lastname: Isunza Ramírez
authors.forename: Alberto
authors.initials: A
authors.lastname: López Marmolejo
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Palma Rosillo
authors.forename: Sergio
authors.initials: S
authors.lastname: Guízar Cuevas
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mora Magaña
authors.forename: Víctor Hugo
authors.initials: VH
authors.lastname: Velázquez Pedroza
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015609:Organotechnetium Compounds; D010019:Osteomyelitis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015609:Organotechnetium Compounds; C431804:Technetium Tc 99m ciprofloxacin; D002939:Ciprofloxacin