Postoperative bone marrow alterations: Potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte scintigraphy

James E. Seabold, James V. Nepola, J. Lawrence Marsh, Donald R. Hawes, Eric P. Justin, James A. Ponto, William A. Pettit, Georges Y. El-Khoury, Peter T. Kirchner

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Scintigraphy was used after injection of technetium-99m methylene diphosphonate (MDP) and indium-111-labeled white blood cells (WBCs) to assess for the presence of osteomyelitis in 97 patients who had undergone prior surgical procedures. Thirty-four patients with abnormal In-111-labeled WBC patterns underwent restudy with Tc-99m albumin colloid (AC). Scintigraphic findings were considered positive for osteomyelitis whenever localization of In111-labeled WBCs exceeded Tc-99m AC activity in extent or focal intensity (discordant pattern). Ten of 12 patients with culture-proved osteomyelitis had discordant patterns; two had false-negative (concordant) patterns. The cases of 20 of 22 patients without infection who were considered to have osteomyelitis on the basis of patterns of In-111-labeled WBCs and Tc-99m MDP were reclassified correctly on the basis of concordant patterns of In-111-labeled WBCs and Tc-99m AC. Radiocolloid images improved the overall scintigraphic specificity for osteomyelitis from 59% without bone marrow imaging to 92%; sensitivity decreased from 94% to 88%.

Original languageEnglish (US)
Pages (from-to)741-747
Number of pages7
JournalRadiology
Volume180
Issue number3
DOIs
StatePublished - Sep 1991

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Keywords

  • Bone marrow, 40.47
  • Bones, infection, 40.216
  • Indium, radioactive

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Seabold, J. E., Nepola, J. V., Marsh, J. L., Hawes, D. R., Justin, E. P., Ponto, J. A., Pettit, W. A., El-Khoury, G. Y., & Kirchner, P. T. (1991). Postoperative bone marrow alterations: Potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte scintigraphy. Radiology, 180(3), 741-747. https://doi.org/10.1148/radiology.180.3.1871288