technetium-tc-99m-medronate and Bone-Diseases--Infectious

Bone infection is a common issue in infectiology. The gold standard for evaluating bone infection is the white blood cell (WBC) scan. In our practice the WBC scan is coupled with a bone scan. Discordances in the results of these two examinations are a common occurrence in daily practice. We decided to investigate the meaning of these discordances.. Two hundred and ninety-six 99mTc-HMPA labelled white blood cells (WBC) and 99mTc-HMDP bone scanning (BS) examinations were performed in our department between 1997 and 2003 for evaluation of bone infection. Out of these 296 examinations, a first rating extracted 54 scans that were considered discordant. These 54 scans were reviewed by three observers. Clinical and paraclinical data were obtained for all the cases definitely considered as discordant by all three observers.. The observers finally retained 18 cases as discordant from the initial 296 (6.1%). Thirteen patients were not infected,and five patients were considered infected based on clinical follow-up or bacteriological and histological data. For the 17 patients with WBC-, BS+, 4 (23.5%) were infected.. Our study shows that in the vast majority(17 out of 18), discordances consist of a negative WBC scan with a positive bone scan. In these cases the accuracy of the WBC scan is diminished as 23.5% of the patients with a negative WBC and a positive bone scan are infected.

Topics: Bone and Bones; Bone Diseases, Infectious; False Negative Reactions; Humans; Leukocytes; Radionuclide Imaging; Retrospective Studies; Staining and Labeling; Technetium Tc 99m Exametazime; Technetium Tc 99m Medronate

Topics: Bone Diseases, Infectious; Citrates; Female; Gallium; Humans; Middle Aged; Multiple Myeloma; Pressure Ulcer; Prognosis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Whole-Body Counting