American Journal of Roentgenology, Vol 158, 9-18, Copyright © 1992 by American Roentgen Ray Society

ARTICLES

The scintigraphic diagnosis of osteomyelitis

DS Schauwecker
Department of Nuclear Medicine, Indiana University School of Medicine, Wishard Memorial Hospital, Indianapolis 46202.

Osteomyelitis is a serious health problem that results in multiple limb amputations annually. This article reviews the current scintigraphic procedures used in the diagnosis of osteomyelitis and discusses some of the newer radiopharmaceuticals now being developed. The goal is to understand the strengths and weaknesses of each method so that the procedure most effective for specific clinical settings can be selected. In general, the three-phase bone scan is the procedure of choice if the suspected osteomyelitis is not superimposed on another disease that causes increased bone remodeling (i.e., findings on the radiograph are normal). If the suspected osteomyelitis is superimposed on a disease that causes increased bone remodeling, the combined 111In- labeled leukocyte-99mTc bone scan is the procedure of choice in the non- marrow-containing skeleton and the 111In-labeled leukocyte and 99mTc bone marrow scans are the procedures of choice in the marrow-containing skeleton.
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