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Right Distal Femur Osteomyelitis

Afiesimama BOA - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Right Distal Femur Osteomyelitis

History: 49yo Caucasian female with a past history of right distal femur osteomyelitis 10 years ago. The patient was treated at that time and was symptom free until 3 months ago, when she began to experience right thigh pain. Approximately one week ago the thigh became erythematous, and began to drain muco-purulent material from newly formed sinus tracts.

Findings: BONE SCAN: Flow and blood pool images over the anterior thighs demonstrate markedly increased tracer accumulation in the right distal femur. These images are made as Technetium phosphate tracer is injected intravenously and immediately thereafter, and hence reflect blood flow (flow phase) and initial blood distribution of tracer (blood pool phase). In this patient the increased tracer accumulation indicates increased regional blood flow in the right distal femur. Bone phase images are taken several hours after initial injection, and they reflect the amount of tracer retained by bone after Technetium has been flushed out of the soft tissues. For reasons not fully understood, Technetium tracer is retained most strongly by bone secreting osteoid. Hence any disease entity which stimulates bone growth (including reactive bone) will produce an abnormal focal increase in tracer accumulation. This patient's bone phase images demonstrate a focal "hot spot" in the same area as the flow and blood pool images, indicating new bone formation. INDIUM WBC STUDY: This study reveals an area of focally increased activity in the right distal femur which corresponds with the bone scan images. These images are produced by labeling the patient's WBCs with indium, and then reinjecting the cells to determine their distribution in the body. The focal increase in WBCs in abnormal areas is fairly specific evidence for infection, and when correlated with an abnormal bone scan, is fairly specific for osteomyelitis.

No MeSH data available.


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MPX1491_synpic38308: See case description


Right Distal Femur Osteomyelitis

Afiesimama BOA - MedPix (2007)

See case description
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1491&req=5

MPX1491_synpic38308: See case description

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Right Distal Femur Osteomyelitis

History: 49yo Caucasian female with a past history of right distal femur osteomyelitis 10 years ago. The patient was treated at that time and was symptom free until 3 months ago, when she began to experience right thigh pain. Approximately one week ago the thigh became erythematous, and began to drain muco-purulent material from newly formed sinus tracts.

Findings: BONE SCAN: Flow and blood pool images over the anterior thighs demonstrate markedly increased tracer accumulation in the right distal femur. These images are made as Technetium phosphate tracer is injected intravenously and immediately thereafter, and hence reflect blood flow (flow phase) and initial blood distribution of tracer (blood pool phase). In this patient the increased tracer accumulation indicates increased regional blood flow in the right distal femur. Bone phase images are taken several hours after initial injection, and they reflect the amount of tracer retained by bone after Technetium has been flushed out of the soft tissues. For reasons not fully understood, Technetium tracer is retained most strongly by bone secreting osteoid. Hence any disease entity which stimulates bone growth (including reactive bone) will produce an abnormal focal increase in tracer accumulation. This patient's bone phase images demonstrate a focal "hot spot" in the same area as the flow and blood pool images, indicating new bone formation. INDIUM WBC STUDY: This study reveals an area of focally increased activity in the right distal femur which corresponds with the bone scan images. These images are produced by labeling the patient's WBCs with indium, and then reinjecting the cells to determine their distribution in the body. The focal increase in WBCs in abnormal areas is fairly specific evidence for infection, and when correlated with an abnormal bone scan, is fairly specific for osteomyelitis.

No MeSH data available.