3-phase Bone Scan and WBC Scan Foot The combined bone scan and labeled leukocyte scan (In-111 or Tc-99m) markedly improves specificity in the nonmarrow-containing skeleton when there has been previous surgery, radiographs are abnormal, or when any other cause for bone remodeling is present [32]. It can be useful for distinguishing true WBC accumulation secondary to osteomyelitis from nonspecific WBC uptake that is seen in neuropathic joint [32,33]. Planar scintigraphic imaging modalities alone have relatively low spatial resolution and lack anatomic specificity. Nuclear medicine modalities are useful in cases where infection is multifocal or when the infection is associated with orthopedic hardware or chronic bone alterations from trauma or surgery. WBC Scan Foot Labeled leukocyte imaging is advantageous for imaging acute infection in immunocompetent patients with intact chemotaxis. The modality is most useful for identifying neutrophil-mediated inflammatory processes, such as bacterial infections, because the majority of leukocytes labeled are neutrophils, and it is less useful in illnesses in which the predominant cellular response is other than neutrophilic, such as tuberculosis. Chronicity of infection and nonspecific inflammation may lead to inconsistent results, and a recent onset neuropathic joint may yield false-positive results [34,35]. Planar scintigraphic imaging modalities have relatively low spatial resolution and lack of anatomic specificity. Nuclear medicine modalities are useful in cases where infection is multifocal or when the infection is associated with orthopedic hardware or chronic bone alterations from trauma or surgery. Suspected Osteomyelitis of the Foot WBC Scan and Sulfur Colloid Scan Foot Combined labeled leukocyte and sulfur colloid bone marrow imaging is most useful when increased labeled leukocyte activity is secondary to altered bone marrow distribution, such as around joint prosthesis [36].
Suspected Osteomyelitis of the Foot in Patients with Diabetes Mellitus. 3-phase Bone Scan and WBC Scan Foot The combined bone scan and labeled leukocyte scan (In-111 or Tc-99m) markedly improves specificity in the nonmarrow-containing skeleton when there has been previous surgery, radiographs are abnormal, or when any other cause for bone remodeling is present [32]. It can be useful for distinguishing true WBC accumulation secondary to osteomyelitis from nonspecific WBC uptake that is seen in neuropathic joint [32,33]. Planar scintigraphic imaging modalities alone have relatively low spatial resolution and lack anatomic specificity. Nuclear medicine modalities are useful in cases where infection is multifocal or when the infection is associated with orthopedic hardware or chronic bone alterations from trauma or surgery. WBC Scan Foot Labeled leukocyte imaging is advantageous for imaging acute infection in immunocompetent patients with intact chemotaxis. The modality is most useful for identifying neutrophil-mediated inflammatory processes, such as bacterial infections, because the majority of leukocytes labeled are neutrophils, and it is less useful in illnesses in which the predominant cellular response is other than neutrophilic, such as tuberculosis. Chronicity of infection and nonspecific inflammation may lead to inconsistent results, and a recent onset neuropathic joint may yield false-positive results [34,35]. Planar scintigraphic imaging modalities have relatively low spatial resolution and lack of anatomic specificity. Nuclear medicine modalities are useful in cases where infection is multifocal or when the infection is associated with orthopedic hardware or chronic bone alterations from trauma or surgery. Suspected Osteomyelitis of the Foot WBC Scan and Sulfur Colloid Scan Foot Combined labeled leukocyte and sulfur colloid bone marrow imaging is most useful when increased labeled leukocyte activity is secondary to altered bone marrow distribution, such as around joint prosthesis [36].