Osteomyelitis in complicated bones: the role of FDG PET/CT

Osteomyelitis in infections encompasses heterogeneous group of condition that frequently have high morbidity and comes at a huge cost to healthcare system. Accurate and early diagnosis is important for the proper management of the condition. FDG PET/CT has been found useful in the osteomyelitis of complicated bones, including prosthetic joint infections, fracture related infections and sternal wound infections. The altered anatomy and the replacement of marrow in some cases of metallic implant makes the use of anatomic-based methods less optimal. FDG PET/CT has been found to be useful under these circumstances, however, it also has its own limitation of lack of specificity especially due to inflammation. Recent meta-analysis of the role of FDG PET/CT in complicated osteomyelitis have result in the validation defined the indications for its use. This has led to the publication of best use criteria and recommendations of by joint committees of major nuclear medicine societies.