Nuclear Medicine Imaging of Peripheral Bone Osteomyelitis and Sternal Wound Infections
Infections in the musculoskeletal system are not uncommon and form a serious healthcare problem with high costs, since often young people are involved, and it leads to huge impact on their daily life. Luckily, nuclear medicine techniques are able to help in the diagnostic pathway in patients with suspected peripheral bone infection.
In this book chapter, two serious infections in the skeleton are discussed: the peripheral bone infection (and dissemination of this infection throughout the body by the blood) and the sternal wound infection. The three most commonly used nuclear medicine imaging techniques (three-phase bone scan/NaF-PET, white blood cell scintigraphy with SPECT/CT, and FDG-PET/CT) are discussed: the best way to perform the acquisition and interpretation (according to the EANM guidelines), the pros and cons of each technique, and the position of each technique within the diagnostic pathway.
Furthermore, the different questions of the referring clinician for us as imaging specialists are mentioned, and it is discussed which imaging technique would be best to use for which indication. This is illustrated by an overview of the recently published guidelines by four European Societies on peripheral bone infection, but is also illustrated by several clinical examples.
KeywordsPeripheral bone infection Sternal infection Bone scan White blood cell scintigraphy FDG-PET/CT Fracture-related infection Diagnosis of infection Diagnostic flowchart
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