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Introduction: Differentiating osteomyelitis (OM) from charcot joint is a vital necessity. Despite having almost  similar presentation, both OM and charcot joint are managed vastly different. This study proposes the use of  combined Sulphur Colloid and Besilosomab (Scintumun) scan to differentiate OM from Charcot Joint based on the  understanding of their dissimilar pathophysiology. Method: Image acquisitions of two patients using the 99mTc-Scintimun and 99mTc-Sulphur colloid were obtained  accordingly at the affected sites. Result: Both patients produced similar images on the combined Sulphur Colloid and Scintimun scans. There  were increased activity on both Sulphur Colloid and Scintimun scans which suggested the exclusion of OM in both  cases. Both patients were treated conservatively by the primary team. Conclusion: The combined study of Scintimun and Sulphur Colloid imaging is a useful tool in assisting the  primary team to exclude OM although a wider data sample is needed to further support this study.

Differentiating Osteomylelitis from Charcot Joint by Using Sulphur Colloid and Besilosomab (Scintimun®) Scan at Sarawak General Hospital