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Gallium-67 Scintigraphy in Tuberculous and Nontuberculous Infectious Spondylitis

Departments of Nuclear Medicine and Radiology, Royal Victoria Hospital, Montreal, Canada

Correspondence: For correspondence or reprints contact: Dr. Robert Lisbona, Department of Nuclear Medicine, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1.

ABSTRACT

Vertebral osteomyelitis is a difficult condition to diagnose clinically. A retrospective review of 21 cases of infectious spondylitis (6 tuberculous, 15 nontuberculous) confirmed the utility of ⁶⁷Ga scintigraphy in imaging this process. Gallium-67 scans were positive at all sites of disease in this patient population. They anticipated the presence of spondylar infection in 23% of regions where radiographic abnormalities were originally lacking, while confirming a current and ongoing septic process at the other sites where vertebral destruction was already present on x-ray. Gallium-67 studies, as compared to the ^99mTc-MDP bone scans, also provided important information as to the extent of disease by documenting the presence of eight paraspinal abscesses and the location of remote extraspinal foci of infection both in soft tissues and in bone. The relative merits of all radiologic imaging procedures are discussed. A diagnostic algorithm is also suggested.

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