RT Journal Article SR Electronic T1 Inability of 99mTc-Ciprofloxacin Scintigraphy to Discriminate Between Septic and Sterile Osteoarticular Diseases JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 920 OP 926 VO 44 IS 6 A1 Laure Sarda A1 Anne-Claude Crémieux A1 Yves Lebellec A1 Alain Meulemans A1 Rachida Lebtahi A1 Gilles Hayem A1 Rémi Génin A1 Nicolas Delahaye A1 Denis Huten A1 Dominique Le Guludec YR 2003 UL http://jnm.snmjournals.org/content/44/6/920.abstract 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.