False negative bone scans in pediatric sepsis of the axial skeleton

The early diagnosis of disk space infections and sacroiliitis in children can be difficult because of protean presenting symptoms, nonspecific laboratory studies, and normal plain films. Technetium phosphate scintigraphy has been reported as a diagnostic method with an accuracy of up to 100% in some series. In this case report we present two patients with negative technetium bone scans in the face of active infection, illustrating the need to pursue the diagnosis using other modalities.