title: The longitudinal assessment of osteomyelitis development by molecular imaging in a rabbit model.
abstract: BACKGROUND
  Osteomyelitis is a severe orthopaedic complication which is difficult to diagnose and treat. Previous experimental studies mainly focussed on evaluating osteomyelitis in the presence of an implant or used a sclerosing agent to promote infection onset. In contrast, we focused on the longitudinal assessment of a nonimplant related osteomyelitis.
  
  
  METHODS
  An intramedullary tibial infection with S. aureus was established in NZW rabbits. Clinical and haematological infection status was evaluated weekly, combined with X-ray radiographs, biweekly injections of calcium binding fluorophores, and postmortem micro-CT. The development of the infection was assessed by micro-PET at consecutive time points using 18F-FDG as an infection tracer.
  
  
  RESULTS
  The intramedullary contamination of the rabbit tibia resulted in an osteomyelitis. Haematological parameters confirmed infection in mainly the first postoperative weeks (CRP at the first 5 postoperative weeks, leucocyte differentiation at the second and sixth postoperative weeks, and ESR on the second postoperative week only), while micro-PET was able to detect the infection from the first post-operative week onward until the end of the study.
  
  
  CONCLUSIONS
  This study shows that osteomyelitis in the rabbit can be induced without use of an implant or sclerosing agent. The sequential follow-up indicates that the diagnostic value of each infection parameter is time point dependant. Furthermore, from all parameters used, the diagnostic value of  18F-FDG micro-PET is the most versatile to assess the presence of an orthopaedic infection in this model.
authors.affiliation: Laboratory for Experimental Orthopaedics, Department of Orthopaedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Jim C E
authors.initials: JC
authors.lastname: Odekerken
authors.affiliation: Laboratory for Experimental Orthopaedics, Department of Orthopaedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Geert H I M
authors.initials: GH
authors.lastname: Walenkamp
authors.affiliation: Department of Nuclear Medicine, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Boudewijn T
authors.initials: BT
authors.lastname: Brans
authors.affiliation: Laboratory for Experimental Orthopaedics, Department of Orthopaedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Tim J M
authors.initials: TJ
authors.lastname: Welting
authors.affiliation: Laboratory for Experimental Orthopaedics, Department of Orthopaedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Jacobus J C
authors.initials: JJ
authors.lastname: Arts
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D019788:Fluorodeoxyglucose F18; D006801:Humans; D057054:Molecular Imaging / Q000379:methods*; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D011817:Rabbits; D011859:Radiography; D019275:Radiopharmaceuticals; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D013211:Staphylococcus aureus / Q000472:pathogenicity; D013977:Tibia / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18