Diagnostic strategies in osteomyelitis

Journal Article · Fri Jun 28 04:00:00 EDT 1985 · Am. J. Med.; (United States)

DOI:https://doi.org/10.1016/0002-9343(85)90388-2· OSTI ID:5245913

Wheat, J

Technetium-/sup 99/ pyrophosphate bone scanning often identifies patients with osteomyelitis before roentgenographic findings appear. However, recent studies have shown that /sup 99/Tc bone scanning often gives false-negative results, especially in neonates. The accuracy of computed tomographic scanning and indium-111 leukocyte scanning for diagnosis of early osteomyelitis has not been established. /sup 99/Tc bone scanning often gives false-positive results in patients with other conditions leading to bone injury and repair, such as trauma or recent surgery, further limiting the usefulness of this imaging procedure. Newer imaging techniques have not been adequately evaluated to establish their specificity. Because of their high cost and unproved accuracy, these new imaging procedures should not be routinely applied until their usefulness has been established. Bone biopsy remains the procedure of choice for establishing the diagnosis in patients suspected clinically to have osteomyelitis with negative findings on roentgenography and /sup 99/Tc bone scanning. Although Staphylococcus aureus is the leading cause of osteomyelitis, other pathogens cause 30 to 40 percent of cases. Aspiration or biopsy of the involved bone is usually required to choose appropriate antibiotic therapy. Bone biopsy is essential in chronic osteomyelitis, since cultures of sinus drainage are unreliable. Osteomyelitis in diabetics with foot infection and in association with decubitus ulcers presents special problems. Radionuclide scanning often give false-positive results in these patients. Proper diagnosis usually requires careful assessment of clinical and roentgenographic findings. 33 references.

• Research Organization: Indiana Univ. Medical Center, Indianapolis
• OSTI ID: 5245913
• Journal Information: Am. J. Med.; (United States), Journal Name: Am. J. Med.; (United States) Vol. 6B; ISSN AJMEA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ACCURACY
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BIOPSY
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
COST
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIABETES MELLITUS
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ENDOCRINE DISEASES
ERRORS
EVALUATION
HOURS LIVING RADIOISOTOPES
INDIUM 111
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LEUKOCYTES
MATERIALS
METABOLIC DISEASES
MINUTES LIVING RADIOISOTOPES
NEONATES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
OSTEOMYELITIS
OXYGEN COMPOUNDS
PATIENTS
PHOSPHORUS COMPOUNDS
PYROPHOSPHATES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SKELETAL DISEASES
SKELETON
TECHNETIUM 99
TECHNETIUM ISOTOPES
YEARS LIVING RADIOISOTOPES