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Indium-111 Chloride Scintigraphy in Adult Osteomyelitis

Department of Radiology, Victoria General Hospital, Halifax, Nova Scotia, Canada

Correspondence: For reprints contact: S. Iles, MD, Dept. of Radiology, Victoria General Hospital, Halifax, Nova Scotia B3H 2Y9, Canada.

ABSTRACT

Osteomyelitis is a common clinical problem that may be difficult to diagnose. We compared the performance of indium-111-labeled white cells ([¹¹¹In]WBC) to ¹¹¹In chloride ([¹¹¹In]Cl) in two groups of adult patients suspected to have osteomyelitis or septic arthritis. Using [¹¹¹In] WBC, 52 scans were performed on 51 patients. Nineteen patients had osteomyelitis. The sensitivity was 84% and specificity 82%. Using [¹¹¹In]Cl, 48 scans were performed on 47 patients. Twelve had osteomyelitis. Sensitivity was 91%, and specificity was 89%. In each group, one false-negative study occurred in vertebral osteomyelitis. Three false-negative studies using [¹¹¹In]WBC were due to failure to distinguish between combined bone and soft-tissue infection and soft-tissue infection alone. False-positive studies in both groups were due to overlying soft-tissue infection or inflammatory arthritis. Chi-squared test showed no significant difference in performance between the two agents. Indium-111 chloride is easier to prepare and use than [¹¹¹In]WBC, which requires a time-consuming labeling process.