Document Detail

Can the three-phase bone scan differentiate osteomyelitis from metabolic or metastatic bone disease?
MedLine Citation:
PMID:  6467758     Owner:  NLM     Status:  MEDLINE    
The three-phase bone scan has been reported of value in the diagnosis of osteomyelitis. The use of a radionuclide angiogram, an immediate postinjection "blood pool" image, and 2 to 3 hour delayed image have been useful in separating nonosseous inflammatory disease from osteomyelitis. However, dependence on increased blood flow and focal hyperemia for this diagnosis may limit the use of the study if other processes are shown to produce similar results. To identify limitations of the three-phase bone scan we studied 14 patients with metastatic bone disease and nine patients with Paget's disease. Blood flow results showed no increase in three of 14 patients with metastases, intermediate increase in seven of 14 patients with metastases and two of nine patients with Paget's, and intense increase in four of 14 patients with metastases and seven of nine patients with Paget's. All patients showed increased focal activity in the immediate "blood pool" and delayed images. We conclude that because of increased flow Paget's disease may be difficult to separate from osteomyelitis. However, metastatic disease can often be differentiated on the basis of quantitative focal hyperemia. The three-phase bone scan remains of value in the diagnosis of osteomyelitis, but other diseases of bone must be included in the differential diagnosis.
R B Shafer; G F Edeburn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  9     ISSN:  0363-9762     ISO Abbreviation:  Clin Nucl Med     Publication Date:  1984 Jul 
Date Detail:
Created Date:  1984-10-10     Completed Date:  1984-10-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  373-7     Citation Subset:  IM    
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MeSH Terms
Bone Diseases, Metabolic / radionuclide imaging*
Bone Neoplasms / radionuclide imaging,  secondary*
Bone and Bones / blood supply,  radionuclide imaging*
Diagnosis, Differential
Middle Aged
Osteitis Deformans / radionuclide imaging
Osteomyelitis / radionuclide imaging*

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