Nuclear medicine imaging of posttraumatic osteomyelitis

• Published in: European Journal of Trauma and Emergency Surgery Vol. 42; no. 4; pp. 397 - 410
• Main Authors: Govaert, G. A. M., Glaudemans, A. W. J. M.
• Format: Journal Article Book Review
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2016; Springer Nature B.V
• Subjects: Bone and Bones - diagnostic imaging; Critical Care Medicine; Emergency Medicine; Humans; Intensive; Medical diagnosis; Medicine; Medicine & Public Health; Nuclear medicine; Nuclear Medicine - trends; Orthopedics; Osteomyelitis - diagnostic imaging; Radionuclide Imaging; Reproducibility of Results; Review; Review Article; Sensitivity and Specificity; Sports Medicine; Surgery; Surgical Orthopedics; Surgical outcomes; Trauma care; Traumatic Surgery; FDG-PET; Nuclear medicine; White blood cell scan; Posttraumatic osteomyelitis; Bone scan
• ISSN: 1863-9933; 1863-9941
• DOI: 10.1007/s00068-016-0647-8

Introduction Early recognition of a possible infection and therefore a prompt and accurate diagnostic strategy is essential for a successful treatment of posttraumatic osteomyelitis (PTO). However, at this moment there is no single routine test available that can detect osteomyelitis beyond doubt and the performed diagnostic tests mostly depend on personal experience, available techniques and financial aspects. Nuclear medicine techniques focus on imaging pathophysiological changes which usually precede anatomical changes. Together with recent development in hybrid camera systems, leading to better spatial resolution and quantification possibilities, this provides new opportunities and possibilities for nuclear medicine modalities to play an important role in diagnosing PTO. Aim In this overview paper the techniques and available literature results for PTO are discussed for the three most commonly used nuclear medicine techniques: the three phase bone scan (with SPECT-CT), white blood cell scintigraphy (also called leukocyte scan) with SPECT-CT and 18 F-fluorodeoxyglucose (FDG)-PET/CT. Emphasis is on how these techniques are able to answer the diagnostic questions from the clinicians (trauma and orthopaedic surgeons) and which technique should be used to answer a specific question. Furthermore, three illustrative cases from clinical practice are described.