Osteomyelitis: early scintigraphic detection in children

Area of Science:

• Pediatric Radiology
• Nuclear Medicine
• Skeletal Imaging

Background:

• Osteomyelitis is a bone infection that can be challenging to diagnose early in children.
• Conventional radiography often lacks sensitivity in the initial stages of pediatric osteomyelitis.

Purpose of the Study:

• To evaluate the efficacy of bone scintigraphy in the early detection of osteomyelitis in children.
• To compare bone scintigraphy findings with radiography, blood cultures, and bone biopsy.

Main Methods:

• Nine pediatric patients (2-13 years) with suspected bone infection underwent technetium Tc 99m diphosphonate bone scintigraphy and radiography.
• Blood cultures were obtained, and bone biopsy or drainage was performed in six patients.

Main Results:

• Bone scintigraphy correctly identified osteomyelitis in seven children, showing focal radiopharmaceutical uptake.
• One patient with a subperiosteal abscess showed central decreased uptake with surrounding increased uptake.
• The patient with cellulitis had normal bone scintigraphy, while radiography showed soft tissue changes. Early osteomyelitis cases often lacked radiographic bony changes.

Conclusions:

• Bone scintigraphy is a valuable tool for the early detection of osteomyelitis in children.
• It can identify bone derangement before radiographic changes are evident, aiding in timely diagnosis and treatment.