Diagnosis of osteomyelitis of the foot in diabetic patients: Value of 111In-leukocyte scintigraphy

Journal Article · Sun Sep 01 04:00:00 EDT 1991 · AJR, American Journal of Roentgenology; (United States)

DOI:https://doi.org/10.2214/ajr.157.3.1872240· OSTI ID:5228451

Larcos, G; Brown, M L; Sutton, R T ^[1]

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1. Section of Nuclear Medicine, Mayo Clinic, Rochester, MN (USA)

The noninvasive diagnosis of osteomyelitis of the foot in diabetic patients with currently available radiologic and radionuclide imaging techniques is often difficult. Recently, 111In-labeled leukocyte scintigraphy has been proposed as an attractive alternative. Accordingly, the authors retrospectively reviewed 51 111In-labeled leukocyte scans, 49 technetium-99m bone scans, and 49 plain radiographs obtained in 51 adults with diabetes in whom osteomyelitis of the foot was suspected. The sensitivity and specificity of these techniques were evaluated in all patients, as well as in a subgroup of 11 patients with neuroarthropathy. Results with 111In-labeled leukocyte scans were also examined in subsets of patients with soft-tissue ulcers (n = 35) and those receiving antibiotics during investigation (n = 20). Confirmation or exclusion of osteomyelitis was made surgically in 28 patients and clinically in 23. Fourteen patients had osteomyelitis. Bone scans were most sensitive (93%) but least specific (43%); plain radiographs were most specific (83%) but least sensitive (43%). 111In-labeled leukocyte scans were both sensitive (79%) and specific (78%), and remained useful in patients with neuroarthropathy, soft-tissue ulcers, and antibiotic treatment. Poor spatial resolution contributed to the false-negative and false-positive 111In-labeled leukocyte scans, suggesting that this technique should not be interpreted independent of other tests. 111In-labeled leukocyte scans are a valuable diagnostic tool for the diagnosis of pedal osteomyelitis in diabetic patients.

• OSTI ID: 5228451
• Journal Information: AJR, American Journal of Roentgenology; (United States), Journal Name: AJR, American Journal of Roentgenology; (United States) Vol. 157:3; ISSN AAJRD; ISSN 0361-803X
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BIOMEDICAL RADIOGRAPHY
BLOOD
BLOOD CELLS
BODY
BODY AREAS
BODY FLUIDS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIABETES MELLITUS
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ENDOCRINE DISEASES
FEET
HOURS LIVING RADIOISOTOPES
INDIUM 111
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LEGS
LEUKOCYTES
LIMBS
MATERIALS
MEDICINE
METABOLIC DISEASES
MINUTES LIVING RADIOISOTOPES
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
OSTEOMYELITIS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SCINTISCANNING
SENSITIVITY ANALYSIS
SKELETAL DISEASES
SPECIFICITY
TECHNETIUM 99
TECHNETIUM ISOTOPES
YEARS LIVING RADIOI