Role of Nuclear Medicine in the diagnosis of musculoskeletal infection: a review

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

“…A reduction of 30% to 50% in bone density is required before the radiographic change is apparent. Thus, the sensitivity and specificity of x-rays to detect acute OM and bone findings are relatively low, in particular during the first 10-14 days of infection [9]. This narrative review aims to summarize the radiological features of the commonest orthopedic infections, the indications and the limits of the different modalities in the diagnostic strategy as well as to recap recent findings that may facilitate diagnosis.…”

“…A reduction of 30% to 50% in bone density is required before the radiographic change is apparent. Thus, the sensitivity and specificity of x-rays to detect acute OM and bone findings are relatively low, in particular during the first 10-14 days of infection [9]. Ultrasound (US).…”

Application of Nuclear Medicine Techniques in Musculoskeletal Infection: Current Trends and Future Prospects

“…Three-phase BS with 99m Tc is often used to rule out peripheral OM in bones unaffected by underlying conditions and is useful for detecting missed multifocal joint infections that have gone unnoticed. OM is diagnosed when focal hyperperfusion and increased bone uptake are found in the area of interest in delayed images (in all three phases), which allows its distinction from cellulitis (high in the first two phases) or septic arthritis (hyperemia in the synovial vessels) [1,3,5,6]. The interest of this test lies in its high negative predictive value of OM and high sensitivity (73-100%), despite its poor specificity [1,3,7].…”

“…To address this issue, fusion imaging scans, such as single-photon emission computed tomography combined with computed tomography (SPECT/CT) and positron emission tomography with CT (PET/CT), have been introduced. These techniques prove valuable in distinguishing between soft tissue and bone infections by providing morphological information [1][2][3]5]. This review offers a comprehensive examination of NM's current and potential future applications for MSK infection management.…”

The Role of Nuclear Medicine Imaging with 18F-FDG PET/CT, Combined 111In-WBC/99mTc-Nanocoll, and 99mTc-HDP SPECT/CT in the Evaluation of Patients with Chronic Problems after TKA or THA in a Prospective Study

“…However, the choice of the most accurate imaging procedure and optimal radiopharmaceutical remains controversial [9]. A literature search reveals different diagnostic accuracies using the same imaging techniques [5,[10][11][12][13][14][15][16][17][18][19][20][21][22], with consecutive agreement that there is no single imaging modality to date (both in the field of radiology or nuclear medicine) that is able to diagnose all possible disorders with satisfactory accuracy [23]. Therefore, a combination of modalities remains necessary in many cases.…”