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Indium‐111 leukocyte scintigraphic detection of subclinical osteomyelitis complicating delayed and nonunion long bone fractures: A prospective study
Author(s) -
Esterhai John L.,
Goll Stephen R.,
McCarthy Kevin E.,
Velchik Michael,
Alavi Abass,
Brighton Carl T.,
Heppenstall R. Bruce
Publication year - 1987
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.1100050102
Subject(s) - scintigraphy , osteomyelitis , nonunion , medicine , subclinical infection , bone scintigraphy , osteitis , gold standard (test) , technetium , radiology , bone infection , prospective cohort study , nuclear medicine , surgery , pathology
Twenty patients were studied prospectively with indium‐labled leukocyte imaging to evaluate its effectiveness in differentiating noninfected delayed or nonunion from osteomyelitis complicating these entities. All patients underwent an open surgical procedure within 24h of the scan. Bone specimens from the nonunion site were obtained for microbiological and histological analysis to confirm the presence or absence of osteomyelitis. In these twenty patients, the sensitivity of the indium scintigraphy was 100%, the specificity 100%, and the overall accuracy 100%. Indium‐labeled leukocyte scintigraphy is significantly more accurate than 99m technetium and 67 gallium imaging had been, when studied earlier, in detecting subclinical osteomyelitis complicating nonunion. Indium‐labeled leukocyte scintigraphy should supplant sequential technetium and gallium studies in this patient population when the surgeon must determine whether subclinical osteomyelitis is complicating fracture management of delayed and nonunions.