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[Sensitivity and specificity of the Tc-99m ciprofloxacin scan in pediatric osteomyelitis]
Félix Gustavo Mora Ríos1, Agustín Isunza Ramírez, Alberto López Marmolejo
1Instituto Nacional de Pediatría. drmoraortoped@hotmail.com
Insights
Technetium Tc-99m ciprofloxacin scans are highly effective for diagnosing bone infections in children. This imaging technique demonstrates excellent sensitivity and specificity in pediatric osteoarticular infection cases.
Area of Science:
- Nuclear Medicine
- Pediatric Infectious Diseases
- Diagnostic Imaging
Background:
- Technetium Tc-99m ciprofloxacin complex is a well-established diagnostic tool for osteoarticular infections.
- Limited data exists on its efficacy in pediatric populations.
- This study addresses the diagnostic utility in children.
Purpose of the Study:
- To evaluate the efficacy of Tc-99m ciprofloxacin scans in diagnosing osteoarticular infections in pediatric patients.
- To determine the sensitivity, specificity, and predictive values of this imaging modality in children.
Main Methods:
- Retrospective, descriptive, observational study of 94 pediatric patients with suspected osteoarticular infection.
- Tc-99m ciprofloxacin bone scan performed, with diagnoses confirmed by intraoperative and blood cultures.
- Analysis of scan results against culture reports to calculate diagnostic accuracy metrics.
Main Results:
- 80.1% of patients had positive bone infections based on cultures.
- Tc-99m ciprofloxacin scans showed 97.6% sensitivity and 100% specificity.
- Positive predictive value was 100%, and negative predictive value was 87.5%.
Conclusions:
- Tc-99m ciprofloxacin complex is a valuable tool for diagnosing bone infections in pediatric patients.
- It aids in differentiating inflammation from infection in suspected cases.
- High accuracy supports its use in pediatric osteoarticular infection diagnosis.
Introduction:
The Tc-99m-ciprofloxacin complex, introduced in 1993, has been extensively evaluated all over the world with good results for the diagnosis of active bacterial osteoarticular infections. There are only a few publications on the use of this procedure in pediatric ages. In our study we evaluated the efficacy of the Tc-99m ciprofloxacin scan for the diagnosis of osteoarticular infections in the pediatric population assessing its sensitivity, specificity, and positive and negative predictive value.
Material And Methods:
A retrospective, descriptive, observational study was done in 94 patients with clinical suspicion of osteoarticular infection in whom a Tc-99m ciprofloxacin bone scan was performed; the diagnosis was confirmed with intraoperative cultures and blood cultures. The results obtained with the Tc-99m ciprofloxacin scan and the culture reports were analyzed, as well as the sensitivity, specificity and the positive and negative predictive values of the Tc-99m ciprofloxacin scan.
Results:
Among the patients with intraoperative and blood cultures, 80 cases (85.1%) were positive and 14 cases (14.9%) were negative for bone infection. In the Tc-99m ciprofloxacin scan 78 cases (83%) were found to be positive for infection and 16 cases (17%) were negative. There were two false negatives. We found a 97.6% sensitivity and 100% specificity, with a 100% positive predictive value and an 87.5% negative predictive value.
Conclusion:
The Tc-99m-ciprofloxacin complex is useful to make the differential diagnosis between inflammation and infection in pediatric patients in whom an osteoarticular infectious process is suspected.
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