THE SCINTIGRAPHIC DIAGNOSIS OF OSTEOMYELITIS

Osteomyelitis is a serious health problem that results in multiple limb amputations annually. This article reviews the current scintigraphic procedures used in the diagnosis of osteomyelitis and discusses some of the newer radiopharmaceuticals now being developed. The goal is to understand the strengths and weaknesses of each method so that the procedure most effective for specific clinical settings can be selected. In general, the three-phase bone scan is the procedure of choice if the suspected osteomyelitis is not superimposed on another disease that causes increased bone remodeling (i.e., findings on the radiograph are normal). If the suspected osteomyelitis is superimposed on a disease that causes increased bone remodeling, the combined In-111-labeled leukocyte-Tc-99m bone scan is the procedure of choice in the non-marrow-containing skeleton and the In-111-labeled leukocyte and Tc-99m bone marrow scans are the procedures of choice in the marrow-containing skeleton.