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Bone scintigraphy in tuberculous spondylodiscitis.

H G Pandit¹, P D Sonsale, S S Shikare

¹Queen Alexandra Hospital, Cosham, Portsmouth, UK.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|July 21, 1999

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Bone scintigraphy is a highly sensitive tool for diagnosing spinal tuberculosis (tuberculous spondylodiscitis), detecting abnormalities in 95% of patients. This imaging technique aids in management before treatment begins.

Area of Science:

Nuclear Medicine
Orthopedic Surgery
Infectious Diseases

Background:

Spinal tuberculosis (tuberculous spondylodiscitis) can present subtly, often missed by plain radiography.
Early and accurate diagnosis is crucial for effective management of spinal tuberculosis.

Purpose of the Study:

To evaluate the diagnostic utility and sensitivity of bone scintigraphy using 99mTc-MDP in patients with suspected tuberculous spondylodiscitis.
To assess the patterns of radionuclide uptake and identify associated lesions in spinal tuberculosis.

Main Methods:

Retrospective analysis of 40 patients who underwent bone scan with 99mTc-MDP prior to anti-tuberculous therapy or surgery.
Evaluation of scintigraphic findings, including uptake patterns, multicentricity, and extra-spinal lesions (skull, ribs).

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Main Results:

Bone scintigraphy demonstrated high sensitivity (95%), with abnormal uptake in 38 out of 40 patients.
Multicentric tuberculous lesions were identified in 25% of cases.
Rib lesions were observed in six patients, characterized by a typical band-like uptake pattern.

Conclusions:

Bone scintigraphy is a valuable and sensitive diagnostic tool for tuberculous spondylodiscitis, surpassing plain radiography in detecting spinal and associated lesions.
The study highlights the advantages and limitations of bone scanning in the comprehensive management of spinal tuberculosis.