PT  - JOURNAL ARTICLE
AU  - Sarda, Laure
AU  - Crémieux, Anne-Claude
AU  - Lebellec, Yves
AU  - Meulemans, Alain
AU  - Lebtahi, Rachida
AU  - Hayem, Gilles
AU  - Génin, Rémi
AU  - Delahaye, Nicolas
AU  - Huten, Denis
AU  - Le Guludec, Dominique
TI  - Inability of <sup>99m</sup>Tc-Ciprofloxacin Scintigraphy to Discriminate Between Septic and Sterile Osteoarticular Diseases
DP  - 2003 Jun 01
TA  - Journal of Nuclear Medicine
PG  - 920--926
VI  - 44
IP  - 6
4099  - http://jnm.snmjournals.org/content/44/6/920.short
4100  - http://jnm.snmjournals.org/content/44/6/920.full
SO  - J Nucl Med2003 Jun 01; 44
AB  - Ciprofloxacin labeled with 99mTc specifically binds to various bacteria. Thus, it potentially constitutes a specific marker allowing discrimination between septic arthritis/osteomyelitis and aseptic osteoarticular diseases. The aim of this prospective study was to evaluate such properties in patients with skeletal diseases. Methods: We prospectively investigated 2 groups of patients: patients with suspected osteoarticular infections (G1, n = 16) and a control group of patients with a presentation of osteoarticular diseases and no sign suggestive of infection (G2, n = 11). All had clinical, biologic, and radiologic evaluations and had 1-, 4-, and 24-h images from 99mTc-ciprofloxacin scintigraphy (370 MBq) before planned biopsy or surgery. For 23 patients, the scintigraphic results were compared with histologic and bacteriologic analyses of biopsy tissue samples; for 4 patients, the scintigraphic results were compared with the findings from 23 ± 5 mo of follow-up. Results: In G1, 99mTc-ciprofloxacin findings were true-positive in all 11 infected sites, true-negative in 2 cases, and false-positive in 3. In G2, 99mTc-ciprofloxacin was true-negative in 4 cases and false-positive in 7. Neither the location of 99mTc-ciprofloxacin activity nor its intensity or kinetics between 1, 4, and 24 h allowed discrimination between infection and aseptic diseases (sterile loosened joint replacement, pseudoarthrosis, or arthrosis). Sensitivity, specificity, and accuracy were 100%, 37.5%, and 63%. Conclusion: 99mTc-Ciprofloxacin scintigraphy showed good sensitivity and a high negative predictive value for the detection of bone and joint infection, but it did not discriminate between infected and aseptic osteoarticular diseases in symptomatic patients referred for surgery.