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Falsely normal radionuclide scans for osteomyelitis

G R Fleisher, J E Paradise, S A Plotkin

    American Journal of Diseases of Children (1960)
    |May 1, 1980
    PubMed
    Summary
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    Technetium scintigrams can appear normal in children with osteomyelitis. Early antibiotic treatment based on clinical suspicion is crucial for diagnosis, as imaging alone may be unreliable.

    Area of Science:

    • Pediatric Infectious Diseases
    • Medical Imaging
    • Skeletal System Infections

    Background:

    • Osteomyelitis diagnosis in children often relies on a combination of clinical presentation and diagnostic imaging.
    • Technetium scintigraphy is a common imaging modality used to detect bone infections.

    Observation:

    • Three pediatric cases of osteomyelitis are presented.
    • All three patients had confirmed osteomyelitis via roentgenogram, blood culture, bone culture, and/or histologic findings.
    • None of the patients exhibited abnormal technetium scintigrams.

    Findings:

    • This study highlights instances where technetium scintigraphy yielded falsely negative results for osteomyelitis.
    • The findings challenge the universal reliability of bone scans in diagnosing pediatric osteomyelitis.

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  • Despite literature suggesting otherwise, these cases show normal bone scans can occur in confirmed osteomyelitis.

    • Implications:

    • Clinical suspicion remains paramount in diagnosing pediatric osteomyelitis, even with non-diagnostic imaging.
    • Antibiotic therapy should be initiated promptly based on clinical judgment when osteomyelitis is suspected.
    • Reliance on a single non-surgical diagnostic procedure, such as technetium scintigraphy, is not advisable for confirming osteomyelitis.