technetium-tc-99m-medronate and Fever

Bone and joint infections are common diseases in pediatrics. They still are a public health problem in Tunisia. The diagnosis is based on clinical, biological, radiological and skeletal scintigraphy arguments. The purpose of this study is to determine the contribution of triple phase bone scan in the exploration of musculoskeletal pain febrile child.. This was a descriptive and retrospective study. It was conducted over a period of 5 years. It has interested all children explored in nuclear medicine department with suspected acute osteomyelitis (OMA) , osteoarthritis (OA) or septic arthritis (SA) referred from Orthopaedic Infantile service. All these patients had, alongside the conventional radiologic exams, a triple phase bone scan HMDP-Tc99m.. We collected 62 patients. Among the selected diagnoses, there were: 22 OMA, 4 OA, 4 SA. The mean age of the patients was 5.58 years with a male predominance. The main reason for consultation was pain. Fever was ≥ 38° C in 80 % of cases. The preferential localization was the lower limb (93.5 %). The quantitative and qualitative bone scan abnormalities objectified led to a correct diagnosis of: 18 OMA, 3 OA and 2 SA with a respectively estimated sensitivity and specificity of 76.6% and 90.6% in the all population.. Bone scan demonstrates early abnormalities allowing osteoaricular infection diagnosis. It highlights the infection site, and draws a map of the lesions. Currently, imaging modalities differ in their availability, their cost, their input and diagnostic accuracy but they are complementary.

Topics: Acute Disease; Adolescent; Arthritis, Infectious; Child; Child, Preschool; Female; Fever; Hospitalization; Humans; Infant; Male; Osteoarthritis; Osteomyelitis; Pain; Pain Management; Predictive Value of Tests; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Tunisia

We present a case of septic arthritis of a lumbar facet joint with an associated epidural abscess. A 13-year-old boy was hospitalized with acute severe back pain and fever after pyonex was done. The infection was precisely localized with magnetic resonance imaging, bone and gallium scintigraphy. He responded to antibiotic therapy. We suppose that the infection was caused by pyonex because the blood cultures were negative, and the patient had an abrupt onset of severe pain and fever 24 h after the acupuncture.

Topics: Acupuncture Therapy; Acute Disease; Adolescent; Anti-Bacterial Agents; Arthritis, Infectious; Epidural Abscess; Fever; Gallium Radioisotopes; Humans; Low Back Pain; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Radiopharmaceuticals; Technetium Tc 99m Medronate; Time Factors; Tomography, X-Ray Computed; Zygapophyseal Joint

To study the clinical usefulness of granulocyte scintigraphy, eight children with clinical, laboratory and/or radiologic findings strongly suggestive of osteomyelitis were prospectively evaluated. Comparison was made with bone scintigraphy and magnetic resonance imaging. In adults, granulocyte scintigraphy is highly infection specific, although nonspecific findings (i.e. photopenic lesions) may also occur. Granulocyte scintigraphy was positive in one patient, false-negative in two and demonstrated nonspecific photopenic lesions in five children (62%). In conclusion, there appears to be little place for granulocyte scintigraphy in routine investigation of suspected ostoemyelitis in children.

Topics: Antibodies, Monoclonal; Bone and Bones; Child; Child, Preschool; False Negative Reactions; Female; Fever; Granulocytes; Humans; Magnetic Resonance Imaging; Male; Osteomyelitis; Pain; Prospective Studies; Radiography; Radioisotopes; Radionuclide Imaging; Sensitivity and Specificity; Technetium; Technetium Tc 99m Medronate

Topics: Aged; Fever; Humans; Indium Radioisotopes; Knee; Male; Osteotomy; Postoperative Complications; Radionuclide Imaging; Technetium Tc 99m Medronate; Tibia

Topics: Acne Vulgaris; Adolescent; Arthritis, Rheumatoid; Body Weight; Diphosphonates; Fever; Humans; Male; Radiography; Radionuclide Imaging; Sacroiliac Joint; Syndrome; Technetium; Technetium Tc 99m Medronate