title: Nuclear medicine imaging of posttraumatic osteomyelitis.
abstract: BACKGROUND
  Early recognition of a possible infection and therefore a prompt and accurate diagnostic strategy is essential for a successful treatment of posttraumatic osteomyelitis (PTO). However, at this moment there is no single routine test available that can detect osteomyelitis beyond doubt and the performed diagnostic tests mostly depend on personal experience, available techniques and financial aspects. Nuclear medicine techniques focus on imaging pathophysiological changes which usually precede anatomical changes. Together with recent development in hybrid camera systems, leading to better spatial resolution and quantification possibilities, this provides new opportunities and possibilities for nuclear medicine modalities to play an important role in diagnosing PTO.
  
  
  OBJECTIVE
  In this overview paper the techniques and available literature results for PTO are discussed for the three most commonly used nuclear medicine techniques: the three phase bone scan (with SPECT-CT), white blood cell scintigraphy (also called leukocyte scan) with SPECT-CT and (18)F-fluorodeoxyglucose (FDG)-PET/CT. Emphasis is on how these techniques are able to answer the diagnostic questions from the clinicians (trauma and orthopaedic surgeons) and which technique should be used to answer a specific question. Furthermore, three illustrative cases from clinical practice are described.
authors.affiliation: Department of Surgery, Subdivision of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Department of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: G A M
authors.initials: GAM
authors.lastname: Govaert
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. a.w.j.m.glaudemans@umcg.nl.
authors.forename: A W J M
authors.initials: AWJM
authors.lastname: Glaudemans
mesh_terms: D001842:Bone and Bones / Q000000981:diagnostic imaging; D006801:Humans; D009683:Nuclear Medicine / Q000639:trends; D010019:Osteomyelitis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Bone scan; FDG-PET; Nuclear medicine; Posttraumatic osteomyelitis; White blood cell scan