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Published on: October 16, 2014
An infected hip prosthesis in a dog diagnosed with a 99mTc-ciprofloxacin (infecton) scan
K Peremans1, F De Winter, L Janssens
1Department of Medical Imaging, Faculty of Veterinary Medicine, University Ghent, Merelbeke, Belgium.
Abstract:
This case report describes the use of the 99mTc-labeled radiopharmaceutical ciprofloxacin (Infecton) in a case of hip prosthesis loosening in a dog. Serial planar radiographs were not conclusive, and culture of the synovial fluid was negative. Antibiotic treatment did not result in improvement of the lameness. Scintigraphy was performed with 99-Tc-Infecton, a tracer claimed to be specific for infection. Antibiotic treatment was interrupted 6 weeks prior to the examination. Planar and tomographic images at 3 h and at 24 h postinjection showed increased activity along the acetabulum and the proximal femoral bone surrounding the femoral prosthesis, indicating focal infection. Bacteriology performed after removal of the implant revealed Pseudomonas aeruginosa.
Insights
Technetium-99m-labeled ciprofloxacin scintigraphy effectively identified a canine hip prosthesis infection. This nuclear medicine technique pinpointed the infection when traditional methods were inconclusive, guiding treatment.
Area of Science:
- Nuclear medicine
- Veterinary orthopedics
- Infectious disease diagnostics
Background:
- Hip prosthesis loosening can be challenging to diagnose, especially when conventional methods like radiography and synovial fluid cultures are inconclusive.
- Focal infection is a common cause of implant loosening and associated lameness in animals.
- Prompt and accurate diagnosis is crucial for successful treatment and implant salvage.
Observation:
- A dog with a loose hip prosthesis presented with persistent lameness unresponsive to antibiotics.
- Radiographs were inconclusive, and synovial fluid cultures were negative for infection.
- Scintigraphy using technetium-99m-labeled ciprofloxacin (99mTc-Infecton) was performed after a 6-week antibiotic washout period.
Findings:
- Planar and tomographic imaging at 3 and 24 hours post-injection revealed increased radiotracer uptake around the acetabulum and proximal femur.
- This focal increased activity indicated a localized infection associated with the hip prosthesis.
- Post-explantation cultures confirmed the presence of Pseudomonas aeruginosa.
Implications:
- 99mTc-Infecton scintigraphy is a valuable tool for diagnosing focal infections in cases of canine hip prosthesis loosening.
- This nuclear imaging technique can provide crucial diagnostic information when other methods fail.
- Accurate localization of infection aids in surgical planning and improves treatment outcomes for orthopedic implant infections.
