indium-oxine and Pain--Postoperative

59 patients with implanted one- or two-sided hip prostheses (n = 74) have been investigated by two different scanning techniques to detect both possible loosening of the prostheses and a possible infection as the cause of the loosening. Of the investigated prostheses 47 were loose; in 45 cases this was evidenced by the bone scan using Tc-99m-DPD, thus showing a sensitivity of 95%. Specificity was 89%. In 21 cases (45%) of loose prostheses an infection could be clinically proven. With the aid of In-111 labeled leukocyte scans, 17 of 21 cases were correctly diagnosed as infected, showing a sensitivity of 91%, while the specificity was 94%. In view of the 93% accuracy, bone scanning can be regarded as the method of choice in detecting loosening of prostheses. The 91% accuracy in proving or ruling out infection by means of the leukocyte scan is high enough to assert correct findings in most cases. The main disadvantage of this method is the very demanding technique for marking of white blood cells.

Topics: Diphosphonates; Hip Joint; Hip Prosthesis; Humans; Indium; Leukocytes; Organometallic Compounds; Organotechnetium Compounds; Oxyquinoline; Pain, Postoperative; Prosthesis Failure; Radionuclide Imaging; Technetium

The radiopharmaceuticals gallium-67 and indium-111 labelled leucocytes have been compared in 15 patients with a painful joint prosthesis in an attempt to identify those patients with periprosthetic infection. Gallium-67 images were abnormal in five out of six patients with periprosthetic infection and normal in seven out of nine without evidence of infection. Indium-111 leucocyte images were abnormal in three out of six patients with infection and normal in all nine patients without infection. Indium-111 labelled leucocyte imaging is technically more difficult to perform than gallium-67 imaging. This, combined with the higher sensitivity of gallium-67 imaging for infection around a prosthetic joint, leads us to conclude that gallium-67 imaging is superior to indium-111 leucocyte imaging in identifying infection as a cause of a painful prosthetic joint.

Topics: Adult; Aged; Bacterial Infections; Female; Gallium Radioisotopes; Hip Prosthesis; Humans; Hydroxyquinolines; Indium; Joint Prosthesis; Knee Prosthesis; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pain, Postoperative; Pelvis; Postoperative Complications; Radioisotopes; Radionuclide Imaging