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Indium-111 Chloride Imaging in Chronic Osteomyelitis

Division of Nuclear Medicine, Department of Radiology and Division of Orthopedic Surgery, Department of Surgery and Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas

Correspondence: For reprints contact: Bettye A. Sayle, MD, Div. of Nuclear Medicine, University of Texas Medical Branch, Galveston, TX 77550.

ABSTRACT

Sixty-eight patients with clinically suspected chronic osteomyelitis were studied with [¹¹¹In]chloride. Fifty-four images were categorized as true positive; seven were categorized as true negative. There were four false-positive studies, two of which were associated with healing cancellous bone graft. There were three false-negative studies in patients previously treated with long-term antibiotic therapy. Images in eight noninfected healing fractures 3 to 8 mo old were normal. Three patients with infected total hip prostheses had positive images. Two patients with loose prostheses had negative images. This study shows that [¹¹¹In]chloride imaging is an accurate way to localize chronic osteomyelitis and may overcome some of the disadvantages of [⁶⁷Ga]citrate such as localization in noninfected healing fractures and in some loose prostheses.