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Epiphyseal Photopenia Associated with Metaphyseal Osteomyelitis and Subperiosteal Abscess

Division of Nuclear Medicine, Departments of Radiology and Orthopedic Surgery, Georgetown University Hospital, Washington, DC

Correspondence: For correspondence or reprints contact: Patrice K. Rehm, MD, Nuclear Medicine, German 2005, Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007-2113.

ABSTRACT

We present a case of metaphyseal osteomyelitis in a child where bone scintigraphy demonstrated photopenia of the distal femoral epiphysis in the absence of infection of the epiphysis or the joint space. A subsequent bone scan demonstrated evolution of the vascular compromise of the epiphysis due to the metaphyseal osteomyelitis complicated by subperiosteal abscess. We discuss the mechanisms and implications of photopenia in the setting of acute bone and joint infection.

Key Words: epiphyseal photopenia • metaphyseal osteomyelitis • subperiosteal abscess • bone scintigraphy