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Importance of dressing removal before radiolabeled WBC imaging for musculoskeletal infection
M Ghesani1, E G Depuey, S Parmett
1Department of Radiology, St. Luke's-Roosevelt Hospital Center, New York, New York, USA.
Abstract:
Leukocyte imaging performed with in-111 or Tc-99m is gaining widespread acceptance as a method for detection of osteomyelitis associated with soft tissue injury or infection. The authors present three cases in which initial imaging was suggestive of a focal infectious process in bone and soft tissue. However, repeat imaging after the removal of wound dressings, which revealed sero-sanguineous discharge in all cases, resulted in a scan appearance that was much less remarkable for focal radiotracer accumulation in the bone. The authors conclude that accumulation of labeled WBCs in wound discharge can result in scans that are false-positive for osteomyelitis. Therefore, the authors recommend that wounds should be cleaned and dressings changed before imaging in order to avoid scans that are false-positive for osteomyelitis.
Insights
Leukocyte imaging can falsely suggest osteomyelitis due to wound discharge. Cleaning wounds before imaging is recommended to prevent false-positive results for this bone infection.
Area of Science:
- Nuclear Medicine
- Radiopharmacology
- Infectious Disease Imaging
Background:
- Leukocyte imaging using Indium-111 (In-111) or Technetium-99m (Tc-99m) is increasingly used for detecting osteomyelitis, especially with coexisting soft tissue injury or infection.
- Initial imaging may indicate a focal infectious process in both bone and soft tissues, necessitating careful interpretation.