Detection of osteomyelitis using FDG and positron emission tomography

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.