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Bone and Soft Tissue

  • Wolfgang Becker
Part of the Developments in Nuclear Medicine book series (DNUM, volume 31)

Abstract

Acute osteomyelitis is clinically suspected in patients with fever, pain, swelling[tumor] and redness as well as warmth, leukocytosis and increased erythrocyte sedimentation rate. The clinical diagnosis of acute osteomyelitis in certain anatomical areas [spine, thigh] with a thick soft tissue surrounding and the diagnosis of chronic osteomyelitits may be difficult. Anyway the early diagnosis and specific diagnosis in posttraumatic patients and diabetic foot patients is essential for a good recovery of the patient without any general or local complication. The clinical problem [i.e. postoperatively] is the differentiation of a normal postoperative irritation or a beginning infection or an infected hematoma. In all these conditions is a need for an infect specific method to help the clinican to answer his questions i.e. - antibiotics: yes or no or operation yes or no.

Keywords

Chronic Osteomyelitis Acute Osteomyelitis Leukocyte Scintigraphy Label Leukocyte White Blood Cell Scintigraphy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Lisbona R, Rosenthall L. Observations on the sequential use of Tc-99m phosphonate complex and Ga-67 imaging in osteomyelitis, cellulitis, and septic arthritis. Radiology 1977; 123; 123–129.Google Scholar
  2. 2.
    Rosenthal L, Lisbona R, Hernandez M, Hadjipavlou A. Tc-99m-PP and Ga-67 imaging following insertion of orthopedic devices. Radiology 1979; 133; 717–721.Google Scholar
  3. 3.
    Becker W, Bair J, Behr Th, et al. Detection of soft-tissue infections and osteomyelitis using a technetium-99m-labelled anti-granulocyte monoclonal antibody fragment. J Nucl Med 1994; 35; 1436–1443.PubMedGoogle Scholar
  4. 4.
    Al-Sheikh W, Sfakianakis GN, Mnaymneh W, et al. Subacute and chronic bone infections: diagnosis using In-111, Ga-67 and Tc-99m-MDP bone scintigraphy and radiography Radiology 1985; 155; 501–506.PubMedGoogle Scholar
  5. 5.
    Alazraki N, Fierer J, Resnick D. Chronic osteomyelitis: Monitoring by Tc-99m-phosphate and Ga-67-citrate Am J Radiol 1985; 145; 767–771.Google Scholar
  6. 6.
    Abramovic J, Rubinstein M. Tc-99m-Nanocolloids: an alternative approach to diagnosis of inflammatory lesions of bones and joints Eur J Nucl Med 1988, 24; 244.Google Scholar
  7. 7.
    Flivik K, Sloth M, Rydholm U, Herrlin K, Lidgren L. Technetium-99m nanocolloid scintigraphy in orthopedic infections: a comparison with Indium-111-labeled leukocytes. J Nucl Med 1993; 34; 1646–1650.PubMedGoogle Scholar
  8. 8.
    Streule K, de Schrijver M, Fridrich R. Tc-99m-labelled HSA nanocolloid versus In-111-oxine labelled granulocytes in detecting skeletal septic processes. Nucl Med Commun 1988; 9; 59–67.PubMedCrossRefGoogle Scholar
  9. 9.
    Vorne M, Lantto S, Paakkinen S, Salo S, Soini I. Clinical comparison of Tc-99m-HMPAO labelled leukocytes and Tc-99m-nanocolloid in the detection of inflammation. Acta Radiol 1989; 30; 633–637.PubMedCrossRefGoogle Scholar
  10. 10.
    Wheeler JG, Slack NF, Duncan A, Palmer M, Harvey RF. Tc-99m-nanocolloids in inflammatory bowel disease. Nucl Med Commun 1990; 11; 127–133.PubMedCrossRefGoogle Scholar
  11. 11.
    McAfee JG, Samin A. In-111-labeled leukocytes: a review of problems in image interpretation. Radiology 155; 1985; 221–229.PubMedGoogle Scholar
  12. 12.
    Propst-Proctor SL, Dillingham MF, McDougall IR, et al. The white blood cell scan in orthopedics. Clin Orthop 169; 1982; 157–165.Google Scholar
  13. 13.
    Mead LP, Scott AC, Bondurant FJ, Browner BD. Indium-111 leukocyte scanning and fracture healing. J Orthop Trauma 4; 1990; 81–84.PubMedCrossRefGoogle Scholar
  14. 14.
    Schmidt KG, Rasmussen JW, Wedebye IM, Frederiksen PB, Pedersen NT. Accumulation of Indium-111-labeled granulocytes in malignant tumors J Nucl Med 29; 1988; 479–484.PubMedGoogle Scholar
  15. 15.
    McCarthy K, Velchik MG, Alavi A, Mandell GA, Esterhai JL, Golf S. Indium-111 labeled white blood cells in the detection of osteomyelitis complicated by a preexistin condition. J Nucl Med 29; 1988; 1015–1021.PubMedGoogle Scholar
  16. 16.
    Datz F, Thorne D. Effect of chronicity of infection on the sensitivity of the In-111-WBC scan. Am J Roentgenol 147; 1986; 809–812.Google Scholar
  17. 17.
    Sfakianakis GN, Al-Sheik W, Heal A, et al. Comparisons of scintigraphy with In-111 leukocytes and Ga-67 in the diagnosis of occult sepsis. J Nucl Med 23; 1982; 618–626.PubMedGoogle Scholar
  18. 18.
    Datz FL. The current status of radionuclide infection imaging in: Freeman LM. Nuclear Medicine Annual 1991 Raven Press, Ltd. New York 1993 47–76.Google Scholar
  19. 19.
    Schauwecker DS, Burt RW, Park HM et al. In-111 white blood cell sensitivity depends on the location of the osteomyelitis. Radiology 165; 1987; 72.Google Scholar
  20. 20.
    Keenan AM, Tindel NL, Alavi A. Diagnosis of pedal osteomyelitis in diabetic patients using current scintigraphic techniques. Arch Intern Med 1989; 149; 2262–2266.PubMedCrossRefGoogle Scholar
  21. 21.
    Maurer AH, Millmond SH, Knight LC, et al. Infection in diabetic osteoarthropathy: use of indium-labelled leukocytes for diagnosis. Radiology 1986; 161; 221–225.PubMedGoogle Scholar
  22. 22.
    Newman LG, Waller J, Palestro CJ, et al. Unsuspected osteomyelitis in diabetic foot ulcers. JAMA 1991; 266; 1246–1251.PubMedCrossRefGoogle Scholar
  23. 23.
    Schauwecker DS, Park HM, Burt RW, Mock BH, Wellman HN. Combined bone scintigraphy and indium-111 leukocytes scans in neutropathic foot disease. J Nucl Med 1988; 29; 1651–1655.PubMedGoogle Scholar
  24. 24.
    Georgi P, Kaps HP, Sinn HJ. Leukozytenszintigraphie bei entzndlichen Prozessen der Wirbelsule. Radiologie 1985;25; 324–328.Google Scholar
  25. 25.
    Palestro CJ, Kim CK, Swyer AJ, Vallabhajosula S, Goldsmith SJ. Radionuclide diagnosis of vertebral osteomyelitis: indium-111 leukocyte and Tc-99m-methylene diphosphonate bone scintigraphy. J Nucl Med 1991; 33; 1861–1865.Google Scholar
  26. 26.
    McCarthy K, Velchik MG, Alavi A, Mandell A, Esterhai JL, Goll S. Indium-111 labeled white blood cells in the detection of osteomyelitis complicated by a pre-existing condition. J Nucl Med 1988; 29; 1015–1021.PubMedGoogle Scholar
  27. 27.
    Schauwecker DS. Osteomyelitis: diagnosis with In-111-labeled leukocytes. Radiology 171; 1989; 141–146.PubMedGoogle Scholar
  28. 28.
    Mok YP, Carney WH, Fernandez-Ulloa M. Skeletal photopenic lesions in In-111-WBC imaging. J Nucl Med 25; 1984; 1322–1326.PubMedGoogle Scholar
  29. 29.
    Brown ML, Häuser MF, Aznarez A, Fitzgerald RH. Indium-111-leukocyte imaging: the skeletal photopenic lesion. Clin Nucl Med 11; 1985; 611–613.CrossRefGoogle Scholar
  30. 30.
    Datz FL, Thorne DA. Cause and significance of cold bone defects on indium-111-labeled leukocyte imaging. J Nucl Med 28; 1987; 820–823.PubMedGoogle Scholar
  31. 31.
    Wukich DK, Van Dam B, Abreu SH. Preoperative indium-labelled white blood cell scintigraphy in suspected osteomyelitis of the axial skeleton. Spine 13; 1988; 1168–1170.PubMedCrossRefGoogle Scholar
  32. 32.
    Whalen JL, Brown ML, McCleod R, Fitzgerald RH. Limitations of indium-leukocyte imaging for the diagnosis of spine infections. Spine 16; 1991; 193–197.PubMedGoogle Scholar
  33. 33.
    Eisenberg B, Power JE, Alavi A. Cold defects in In-111-labeled leukocyte imaging of osteomyelitis in the axial skeleton. Clin Nucl Med 16; 1991; 103–106.PubMedCrossRefGoogle Scholar
  34. 34.
    McCarthy K, Velchik MG, Alavi A, Mandell GA, Esterhai JL, Goll S. Indium-111 labelled white blood cells in the detection of osteomyelitis complicated by a pre-existing condition. J Nucl Med 29; 1988; 1015–1021.PubMedGoogle Scholar
  35. 35.
    Wukich DK, Abreu SH, Callaghan JJ, et al. Diagnosis of infection by preoperative scintigraphy with indium-labeled leukocytes. J Bone Joint Surg [A] 69; 1987, 1353–1360.Google Scholar
  36. 36.
    Palestro CJ, Kim CK, Swyer AJ, Vallabhajosula S, Goldsmith S. Radionuclide diagnosis of vertebral osteomyelitis: Indium-111 leukocyte and technetium-99m-methylene diphosphonate bone scintigraphy. J Nucl Med 32; 1991;1861–1865.PubMedGoogle Scholar
  37. 37.
    Coleman RE, Welch D. Possible pitfalls with clinical imaging of indium-111 leukocytes: concise communication. J Nucl Med 21; 1980; 122–125.PubMedGoogle Scholar
  38. 38.
    Borin BF, Abghari R, Sarkissian A. Skeletal photopenic appearance of Pagefs disease with indium-111 white blood cell imaging. Clin Med Nucl 12; 1987; 783–784.CrossRefGoogle Scholar
  39. 39.
    Dunn EK, Vaquer RA, Strashun MA. Pagets disease: a cause of photopenic skeletal defect in indium-111 wbc scintigraphy. J Nucl Med 29; 1988; 561–563.PubMedGoogle Scholar
  40. 40.
    Palestro CJ, Swyer AJ, Kim CK, Vega A, Goldsmith SJ. Appearance of Paget’s disease on In-111-leukocyte images. J Nucl Med 30; 1989; 755.Google Scholar
  41. 41.
    Swyer AJ, Palestro CJ, Kim CK, Goldsmith SJ. Appearance of fibrous dysplasia on In-111-labeled leukocyte scintigraphy. Clin Nucl Med 16; 1991; 133–135.PubMedCrossRefGoogle Scholar
  42. 42.
    Becker W. The contribution of nuclear medicine to the patient with infection Eur J Nucl Med 22; 1995;1195–1211.PubMedCrossRefGoogle Scholar
  43. 43.
    Becker W, Schomann E, Fischbach W, Brner W, Grüner KR. Comparison of Tc-99mHMPAO and In-111 oxine labelled granulocytes in man: first clinical results. Nucl Med Commun 9; 1988; 435–447.PubMedCrossRefGoogle Scholar
  44. 44.
    Peters AM, Danpure HJ, Osman S, et al. Clinical experience with Tc-99m hexamethylpropylene amine oxime for labelling leukocytes and imaging inflammation. Lancet 2; 1986; 946–949.PubMedCrossRefGoogle Scholar
  45. 45.
    De villers A, Moisan A, Jean S, Arvieux C, Bourguet P. Technetium-99m hexamethylpropylene amine oxime leukocyte scintigraphy for the diagnosis of bone and joint infections: a retrospective study in 116 patients. Eur J Nucl Med 1995; 22;302–307.CrossRefGoogle Scholar
  46. 46.
    El Esper I, Dacquet V, Paillard J, Bascoulergue G, Tahon MM, Fonroget J. Tc-99m-HMPAO labelled leukocyte scintigraphy in suspected chronic osteomyelitis related to an orthopaedic device: clinical usefulness. Nucl Med Commun 1992; 13; 799–805.PubMedCrossRefGoogle Scholar
  47. 47.
    Moragas M, Lomena F, Herranz R. et al. Tc-99m-HMPAO leukocyte scintigraphy in the diagnosis of bone infection. Nucl Med Commun 12; 1991; 417–427.PubMedCrossRefGoogle Scholar
  48. 48.
    Roddie ME, Peters AM, Danpure HJ, et al. Inflammation: imaging with Tc-99m-HMPAO-labeled leukocytes. Radiology 1988; 166; 767–772.PubMedGoogle Scholar
  49. 49.
    Vorne M, Soini I, Lantto T, Paakkinen S. Technetium-99m HMPAO labelled leukocytes in the detection of inflammatory lesions: comparison with Ga-67 citrate. J Nucl Med 30; 1989; 1332–1336.PubMedGoogle Scholar
  50. 50.
    Winker KH, Reuland P, Weiler S, Feine U. Infektionsdiagnostik in der Chirurgie des Bewegungsapparates mit der Tc-99m-HMPAO-Leukozytenszintigraphie Langenbecks. Arch Chir 374; 1989; 200–207.CrossRefGoogle Scholar
  51. 51.
    Reuland P, Winker KH, Heuchert T, Ruck P, Mller-Schauenburg W, Weller S, Feine U. Detection of infection in postoperative orthopedic patients with Tc-99m labeled monoclonal antibodies against granulocytes. J Nucl Med 32; 1991; 526–531.Google Scholar
  52. 52.
    Hotze A, Briele B, Overbeck B, et al. Tc-99m-labelled antigranulocyte antibodies in suspected bone infection. J Nucl Med 1992; 33; 526–531.PubMedGoogle Scholar
  53. 53.
    Dominguez-Gadea I, Martin-Curto LM, de la Calle H, Crespo A. Diabetic foot infections: scintigraphic evaluation with Tc-99m-labelled anti-granulocyte antibodies. Nucl Med Commun 1993; 14; 212–218.PubMedCrossRefGoogle Scholar
  54. 54.
    Alazraki N, Fierer J, Resnik D. Chronic osteomyelitis: monitoring by Tc-99m-phosphonates and Ga-67 citrate imaging. Am J Roentgenol 145; 1985; 767–771.Google Scholar
  55. 55.
    Fishman AJ, Rubin RH, Khaw BA, et al. Detection of acute inflammation with In-111 labeled non-specific polyclonal IgG. Sem Nucl Med 18; 335–344; 1988.CrossRefGoogle Scholar
  56. 56.
    Oyen WJG, van Horn JR, Claessens RAMJ, Sloof TJJH, van der Meer JWM, Corstens FHM. Diagnosis of bone joint and joint prosthesis infections with In-111-labelled specific human immunoglobulin G scintigraphy. Radiology 182; 195–199; 1992.PubMedGoogle Scholar
  57. 57.
    Oyen WJG, Claessens RAMJ, van Horn JR, van der Meer JWM, Corstens FHM. Scintigraphic detection of bone and joint infections with indium 111 labeled nonspecific polyclonal human immunoglobulin G. J Nucl Med 31; 403–412; 1991.Google Scholar
  58. 58.
    Oyen WJG, Netten PM, Lemmens AM, et al. Evaluation of infectious diabetic foot complications with indium-111 labeled human unspecific immunoglobulin G. J Nucl Med 33; 1330–1336; 1992.PubMedGoogle Scholar
  59. 59.
    Sciuk J, Brandau W, Vollet B, et al Comparison of Tc-99m polyclonal human immunoglobulin and Tc-99m monoclonal antibodies for imaging chronic osteomyelitis. Eur J Nucl Med 18; 401–407; 1991.PubMedCrossRefGoogle Scholar
  60. 60.
    de Bois MAW, Arndt JW, van der Velde EA, et al. Tc-99m human immunoglobulin scintigraphy-a reliable method to detect joint activity in rheumatoid arthritis. J Rheumatol 19; 1371–1376; 1992.PubMedGoogle Scholar
  61. 61.
    de Bois MHW, Arndt JW, Tak PP, et al. Tc-99m labelled polyclonal human immunoglobulin G scintigraphy before and after intraarticular knee injection of triamcinolone hexacetonide in patients with rheumatoid arthritis. Nucl Med Commun 14; 883–887; 1993.PubMedCrossRefGoogle Scholar
  62. 62.
    Becker W, Bair J, Behr T, et al. Detection of soft tissue infections and osteomyelitis using a technetium-99m-labeled antigranulocyte monoclonal antibody fragment. J Nucl Med 35; 1436–1443; 1994.PubMedGoogle Scholar
  63. 63.
    Bomanji J, Solanki KK, Britton K, Siraj Q, Small M. Imaging infection with Tc-99m-radiolabeled infecton. Eur J Nucl Med 20; 834; 1993.Google Scholar
  64. 64.
    Keelaan ETM, Harrison AA, Chapman PT, Binns RM, Peters AM, Haskard DO. Imaging vascular endothelial activation: an approach using radiolabeled monoclonal antibodies against the endothelial cell adhesion molecul E-selectin. J Nucl Med 35;276–281; 1994.Google Scholar
  65. 65.
    Signore A, Parman A, Pozilli P, Andreani D, Beverley PCL. Detection of activated lymphocytes in endocrine pancreas of BB/W rats by injection of I-123-interleukin-2: an early sign of type-1 diabetes Lancet II; 537–541; 1987.CrossRefGoogle Scholar
  66. 66.
    Van der Laken, Boerman OC, Oyen WJG, et al. Recombinant human interleukin-1: potential agent to image infectious foci. Eur J Nucl Med 21; 790; 1994.Google Scholar
  67. 67.
    Schiffmann E, Corcoran BA, Wahl SM. Formylmethionyl peptides as chemoattractants for leukocytes. Proc Natl Acad Sci USA 72; 1059–1062; 1972.CrossRefGoogle Scholar
  68. 68.
    Becker EJ. The formylpeptide receptor of the neutrophil: a search and conserve operation Am J Pathol 129; 16–24; 1987.Google Scholar
  69. 69.
    Fischman AJ, Babich JW, Rubin RH. Infection imaging with technetium-99m-labelled chemotactic peptide analogs. Sem Nucl Med 24; 154–168; 1994.CrossRefGoogle Scholar

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© Springer Science+Business Media Dordrecht 1998

Authors and Affiliations

  • Wolfgang Becker

There are no affiliations available

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