Role of scintigraphy in musculoskeletal and spinal infections

Radiol Clin North Am. 2001 Mar;39(2):169-89. doi: 10.1016/s0033-8389(05)70271-2.

Abstract

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 first and may be sufficient. In children, bone scan is highly accurate to diagnose osteomyelitis. Labeled leukocytes with complementary bone or bone marrow studies are recommended for orthopedic hardware or diabetic foot. Finally, gallium scanning is useful for the diagnosis of vertebral osteomyelitis. Current radiopharmaceuticals used for diagnosing infection also label inflammation. Newer products, as Infecton, should in the future allow better differentiation between infection and sterile inflammation.

Publication types

  • Review

MeSH terms

  • Arthritis, Infectious / diagnostic imaging
  • Bacterial Infections / diagnostic imaging*
  • Bone and Bones / diagnostic imaging
  • Humans
  • Muscular Diseases / diagnostic imaging
  • Musculoskeletal Diseases / diagnostic imaging*
  • Osteomyelitis / diagnostic imaging
  • Osteomyelitis / etiology
  • Radionuclide Imaging
  • Radiopharmaceuticals*

Substances

  • Radiopharmaceuticals