Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells

D. K. Wukich, S. H. Abreu, J. J. Callaghan, D. Van Nostrand, C. G. Savory, D. F. Eggli, J. E. Garcia, B. H. Berrey

Research output: Contribution to journalArticle

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Abstract

Scintigraphy with indium-labeled white blood cells has been reported to be sensitive and specific in the diagnosis of low-grade sepsis of the musculoskeletal system. We reviewed the records of fifty patients who had suspected osteomyelitis or suspected infection about a total joint prosthesis and who underwent scintigraphy with technetium-99m methylene diphosphonate and scintigraphy with indium-111 oxine labeled white blood cells before an open surgical procedure. Any patient who received preoperative antibiotics was not included in the study. For all of the patients, gram-stain examination of smears, evaluation of a culture of material from the operative site, and histological examination were done. The patients were divided into two groups. Group I was composed of twenty-four patients, each of whom had a prosthesis in place and complained of pain. Group II was composed of twenty-six patients for whom a diagnosis of chronic osteomyelitis had to be considered. With the indium scans alone, there was only one false-negative result (in Group II), but there were eighteen false-positive results (eight patients in Group II and ten patients in Group I). Although scintigraphy with indium-labeled white blood cells is quite sensitive, it is not specific in detecting chronic osteomyelitis; a negative scan should be considered highly suggestive that osteomyelitis is not present. Specificity can be increased by interpreting the indium scan in conjunction with the technetium scan.

Original languageEnglish (US)
Pages (from-to)1353-1360
Number of pages8
JournalJournal of Bone and Joint Surgery - Series A
Volume69
Issue number9
StatePublished - Dec 1 1987

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Indium
Radionuclide Imaging
Leukocytes
Osteomyelitis
Infection
Technetium
Joint Prosthesis
Technetium Tc 99m Medronate
Musculoskeletal System
Prostheses and Implants
Sepsis
Anti-Bacterial Agents
Pain

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Orthopedics and Sports Medicine

Cite this

Wukich, D. K., Abreu, S. H., Callaghan, J. J., Van Nostrand, D., Savory, C. G., Eggli, D. F., ... Berrey, B. H. (1987). Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells. Journal of Bone and Joint Surgery - Series A, 69(9), 1353-1360.

Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells. / Wukich, D. K.; Abreu, S. H.; Callaghan, J. J.; Van Nostrand, D.; Savory, C. G.; Eggli, D. F.; Garcia, J. E.; Berrey, B. H.

In: Journal of Bone and Joint Surgery - Series A, Vol. 69, No. 9, 01.12.1987, p. 1353-1360.

Research output: Contribution to journalArticle

Wukich, DK, Abreu, SH, Callaghan, JJ, Van Nostrand, D, Savory, CG, Eggli, DF, Garcia, JE & Berrey, BH 1987, 'Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells', Journal of Bone and Joint Surgery - Series A, vol. 69, no. 9, pp. 1353-1360.
Wukich DK, Abreu SH, Callaghan JJ, Van Nostrand D, Savory CG, Eggli DF et al. Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells. Journal of Bone and Joint Surgery - Series A. 1987 Dec 1;69(9):1353-1360.
Wukich, D. K. ; Abreu, S. H. ; Callaghan, J. J. ; Van Nostrand, D. ; Savory, C. G. ; Eggli, D. F. ; Garcia, J. E. ; Berrey, B. H. / Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells. In: Journal of Bone and Joint Surgery - Series A. 1987 ; Vol. 69, No. 9. pp. 1353-1360.
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