Subacute and chronic bone infections: diagnosis using In-111, Ga-67 and Tc-99m MDP bone scintigraphy, and radiography.

Abstract

The usefulness of 111In white blood cell [WBC] scintigraphy in the diagnosis of subacute or chronic bone infection was examined in 21 orthopedic patients. 111In WBC imaging was compared with 67Ga and 99mTc methylene diphosphonate [MDP] skeletal scintigraphy and bone radiography, all studies being performed within 1 wk. 111In WBC scintigraphy showed no definite advantage over 67Ga scintigraphy in the identification of chronic bone infection. The 2 tests had the same sensitivity (80%) and similar specificity (111In WBC 75%, 67Ga 83%; difference not significant). Bone radiography had a sensitivity of 60% and a specificity of 67%. A negative 99mTc MDP bone scintigram ruled out infection (sensitivity 100%), but because of low specificity (25%), final evaluation required performance of 67Ga or 111In WBC scintigraphy.