Role of Scintigraphy in Musculoskeletal and Spinal Infections
Section snippets
RADIOPHARMACEUTICALS
In recent years, a considerable number of radiopharmaceuticals have entered the field of nuclear medicine. From myocardial imaging to neuroendocrine tumor evaluation, they provide new insight into many diseases. The detection of infection and inflammation has not been left behind. In addition to bone agents, gallium, and labeled leukocytes, new exciting substances are being developed and some are already used in clinical practice.
MUSCULOSKELETAL INFECTIONS IN ADULTS
Musculoskeletal infections in adults may have a relatively benign course (e.g., cellulitis) or catastrophic consequences (e.g., in vertebral osteomyelitis complicated by epidural abscess).
MUSCULOSKELETAL INFECTIONS IN CHILDREN
In the pediatric population, untreated musculoskeletal infections can lead to permanent damage to the bone and joint. Nuclear medicine plays an important role in the diagnosis of such infections.
SUMMARY
Clinical findings are still the mainstay for suspecting the diagnosis of musculoskeletal infections, especially osteomyelitis. No single complementary imaging technique has 100% specificity and sensitivity for every case of musculoskeletal infection. Depending on the age of the patient, presence of orthopedic hardware, location of infection, underlying bone, and systemic conditions, the choice of imaging modalities must be tailored to the patient's condition. Plain radiographs are performed
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2016, Clinical RadiologyCitation Excerpt :Of note, no cases of mycobacterial infection were found, which likely reflects regional variation in the incidence of spinal tuberculosis that previous studies have shown to account for 0–65% of culture-positive discitis/osteomyelitis in developed countries.9,11 Also consistent with previous reports is the finding that the lumbar spinal levels were the most likely to be affected, followed by the thoracic spine.21,22 It has been suggested that longer antibiotic duration may have a greater negative effect on the biopsy yield.
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2015, Best Practice and Research: Clinical RheumatologyCitation Excerpt :Bone scintigraphy is a very sensitive method in detecting bone and joint infections, but it is not specific as it rarely is able to distinguish infection from other pathology. Labeled leukocyte scan has a role to play in the diagnosis of prosthetic joint infections as MRI has a lesser utility [143]. Aspiration of the joints is classically done to diagnose joint infections in large joints, both native and prosthetic [137].
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2014, Archives de PediatrieBrain and Spinal Cord
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Address reprint requests to Sophie Turpin, MD, FRCPC, Nuclear Medicine, Medical Imaging, Montréal Children's Hospital, 2300 Tupper Street, Montréal, QC, H3H 1P3 Canada
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Division of Nuclear Medicine, Department of Medical Imaging, Montréal Children's Hospital; Department of Nuclear Medicine, Hôpital-Ste-Justine; and Department of Nuclear Medicine, CHUM Hôtel-Dieu de Montréal, Montréal, Québec, Canada