Indian Journal of Nuclear Medicine
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ORIGINAL ARTICLE
Year : 2012  |  Volume : 27  |  Issue : 3  |  Page : 164-171

Diagnosis of bone infection by complementary role of technetium-99m MDP and technetium-99m hexamethylpropylene-amineoxime-leukocytes


1 Department of Orthopedic, Faculty of Medicine, Taif University, Taif, Saudi Arabia
2 Department of Medical Imaging, Faculty of Medicine, Taif University, Taif, Saudi Arabia
3 Nuclear medicine department, Al-Hada Armed Force Hospital, Taif, Saudi Arabia

Correspondence Address:
Khaled El-Saban
Department of Medical Imaging, Faculty of Medicine, Taif University, Taif
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.112721

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Purpose: Valuate complementary role of 99m Tc-MDP bone scan and 99m Technetium hexamethylpropylene-amineoxime ( 99m Tc-HMPAO) labeled leukocyte scintigraphy in diagnosis of bone infection. Patients and Methods: Ninety one sites suspected to have bone infection were divided in to two groups: Group I 49 sites with current endo-prothesis; and group II 42 sites with no prosthesis. All patients were subjected to serial images of 99m Tc-HMPAO labeled leukocyte ( 99m Tc-white blood cells (WBCs)), triple phase bone scan ( 99m Tc-MDP) and plain X-ray, in addition to clinical and bacteriological assessment, together with follow-up. Results: The overall sensitivity (Sn) was found to be 34.9%, 95.4%, and 86% for plain X-ray, 99m Tc-MDP, and 99m Tc-WBCs respectively. Concerning specificity (Sp) was found to be 47.9%, 45.8%, and 91.7% respectively for the three imaging modalities. 99m Tc-WBCs showed better Sn, Sp, and accuracy in group I (95%, 93.1% and 93.9%, respectively) compared to 40%, 41.4%, and 40.8% for plain X-ray and 90%, 62%, and 73.5% respectively for 99m Tc-MDP. On the other hand, 99m Tc-MDP proved to have best Sn 100% versus 78.3% and 30.4% for 99m Tc-WBCs and plain X-ray respectively. Yet, Sp and accuracy was found to best for 99m Tc-WBCs (89.5% and 83.3% respectively) compared to 57.9% and 42.9% for plain X-ray and 21.1% and 64.3% for 99m Tc-MDP. Conclusion: Combined imaging with 99m Tc-WBCs and 99m Tc-MDP proved to be effective in early detection of bone infection in the presence or absence of prosthesis.


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