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False-normal bone imaging in spinal tuberculosis.

M H Pui, H B Chin-Sang, J D Rubenstein

Clinical Nuclear Medicine

|April 1, 1986

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Technetium-99m methylene diphosphonate (Tc-99m MDP) bone scans for spinal tuberculosis can be normal, even with active infection. A normal scan does not rule out tuberculous spondylitis, necessitating further investigation when suspected.

Area of Science:

Nuclear Medicine
Infectious Diseases
Spinal Imaging

Background:

Spinal tuberculosis (tuberculous spondylitis) is a significant cause of spinal infection.
Tc-99m MDP bone scintigraphy is a common imaging modality for evaluating bone involvement.

Observation:

Typically, Tc-99m MDP bone scans show increased radiotracer uptake at sites of spinal tuberculosis.
However, normal bone scan findings can occur in cases of low-grade, indolent, or severely destructive tuberculous spondylitis.

Findings:

This report details two cases of spinal tuberculosis presenting with normal bone imaging results.
A normal bone scan does not exclude the diagnosis of tuberculous spondylitis.

Implications:

Related Experiment Videos

Clinicians should maintain a high index of suspicion for tuberculous spondylitis even with negative bone scans.

Further diagnostic workup, including tissue biopsy for microbiological and histological examination, is crucial when clinical suspicion is high.