Quantitative 99mTc-MDP and 99mTc-HMPAO WBC Scan Results in Violated Peripheral Bone with Their Definitive Diagnosis
| Patient no. | Underlying pathology | 99mTc-MDP A/N | 99mTc-HMPAO A/N | Scan report | Diagnostic criteria | Antibiotic therapy | Definitive diagnosis |
|---|---|---|---|---|---|---|---|
| 1 | Fracture | 1.3 | 1.1 | Negative | Clinical | No | TN |
| 2 | Fracture | 2.6 | 2.2 | Positive | Bone biopsy | Yes | TP |
| 3 | Fracture | 1.4 | 1.2 | Negative | Clinical | No | TN |
| 4 | Fracture | 2.7 | 1.6 | Positive | Bone biopsy | No | FP |
| 5 | Fracture | 4.1 | 1.9 | Positive | Bone biopsy | Yes | TP |
| 6 | Fracture | 2.4 | 1.5 | Positive | Bone biopsy | Yes | TP |
| 7 | Fracture | 1.3 | 1.2 | Negative | Clinical | No | TN |
| 8 | Fracture | 2.2 | 1.5 | Positive | Clinical | Yes | TP |
| 9 | Fracture | 2.9 | 1.8 | Positive | Bone biopsy | Yes | TP |
| 10 | Fracture | 1.3 | 1.4 | Positive | Clinical | Yes | TP |
| 11 | Prosthesis | 2.1 | 1.5 | Positive | Bone biopsy | Yes | TP |
| 12 | Prosthesis | 1.4 | 1.5 | Positive | Bone biopsy | Yes | TP |
| 13 | Prosthesis | 2.1 | 1.7 | Positive | Clinical | No | FP |
| 14 | Prosthesis | 1.3 | 1.4 | Positive | Bone biopsy | Yes | TP |
| 15 | Prosthesis | 1.6 | 2.1 | Positive | Bone biopsy | Yes | TP |
| 16 | Prosthesis | 2.0 | 2.1 | Positive | Bone biopsy | Yes | TP |
| 17 | Prosthesis | 4.8 | 1.2 | Negative | Clinical | No | TN |
| 18 | Diabetic foot ulcers | 6.2 | 2.1 | Positive | Bone biopsy | Yes | TP |
| 19 | Diabetic foot ulcers | 5.0 | 2.0 | Positive | Bone biopsy | Yes | TP |
| 20 | Diabetic foot ulcers | 4.4 | 2.1 | Positive | Bone biopsy | Yes | TP |
| 21 | Diabetic foot ulcers | 4.8 | 2.0 | Positive | Bone biopsy | Yes | TP |
| 22 | Chronic osteomyelitis | 2.9 | 1.1 | Negative | Clinical | No | TN |
| 23 | Chronic osteomyelitis | 1.3 | 1.0 | Negative | Clinical | No | TN |
| 24 | Chronic osteomyelitis | 1.3 | 1.1 | Negative | Clinical | No | TN |
Negative = 99mTc-MDP and 99mTc-HMPAO WBC scans reported negative for osteomyelitis; positive = 99mTc-MDP and 99mTc-HMPAO WBC scans reported positive for osteomyelitis; clinical = clinical follow-up shows good response to antibiotic therapy and resolving radiologic and clinical findings; absence of bone infection was also confirmed by uneventful clinical and radiologic follow up without antibiotic therapy.
Definitive diagnostic criterion was bone biopsy with culture and sensitivity. For bone scanning, sensitivity = 100% and specificity = 30%. For HMPAO WBC scanning, sensitivity = 100% and specificity = 78%.