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Detection of osteomyelitis using FDG and positron emission tomography
O P Temmerman1, I C Heyligers, O S Hoekstra
1Department of Orthopaedic Surgery, PET Centre, University Hospital Vrije Universiteit, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
The Journal of Arthroplasty
|February 27, 2001
Summary
Positron emission tomography (PET) scans using 2-[fluorine-18]fluoro-2-deoxy-D-glucose ((18)FDG) effectively identified an infection focus in a patient with a hip prosthesis. This imaging technique confirmed subtle clinical signs, locating the infection in the distal right femur.
Area of Science:
- Nuclear medicine imaging
- Infectious disease diagnostics
- Orthopedic imaging
Background:
- Post-surgical infections, particularly after hip prosthesis removal, present diagnostic challenges.
- Conventional imaging like bone scans and radiographs often show indistinct signs of infection.
- Early and accurate diagnosis is crucial for effective treatment and patient outcomes.
Observation:
- A patient presented with clinical and laboratory indicators of infection following hip prosthesis removal.
- Bone scan and radiographic findings were inconclusive for localizing the infection.
- Positron emission tomography (PET) scan using 2-[fluorine-18]fluoro-2-deoxy-D-glucose ((18)FDG) was performed for further evaluation.
Findings:
- The (18)FDG PET scan confirmed the presence of infection, aligning with clinical and laboratory data.
- The imaging successfully identified an otherwise undetected focus of infection.
- The specific site of infection was localized to the distal area of the right femur.
Implications:
- FDG PET imaging offers superior sensitivity and specificity for detecting subtle foci of osteomyelitis compared to conventional methods.
- This technique can aid in guiding targeted antimicrobial therapy and surgical interventions in complex orthopedic infections.
- PET imaging plays a vital role in managing challenging post-prosthetic joint infection cases.