Diagnostic value of bone scintigraphy in osteomyelitis of the mandible

Thirty-five patients each with a tentative diagnosis of osteomyelitis of the mandible were examined with 99Tcm-labeled phosphorus compounds. The scintigraphic findings were compared with the radiographic features and related to disease stages to evaluate the diagnostic potential of bone scintigraphy in different disease stages. The scintigraphy was valuable to exclude bone tissue involvement in some patients with clinical signs and symptoms similar to those of osteomyelitis and with equivocal radiographic findings. In 13 patients with chronic osteomyelitis, scintigraphy revealed a larger extent of the lesion than the radiography. In lesions with permeated bone destructions with penetration of the cortex, the uptake of 99Tcm was higher than in lesions with a motheaten or sclerotic appearance. This study supports the view that 99Tcm-bone scintigraphy is a useful tool at various stages of osteomyelitis, that is, in its early detection, in the treatment or biopsy planning, and in the evaluation of the efficacy of treatment.