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In imaging of infections, the gallium scan has a sensitivity advantage over the indium white blood cell scan in imaging osteomyelitis (bone infection [3]) of the spine, lung infections and inflammation, and in detecting chronic infections. In part, this is because gallium binds to neutrophil membranes, even after neutrophil death, whereas ...
Gallium scans are 100% sensitive for osteomyelitis but not specific, and may be helpful in patients with metallic prostheses. Combined WBC imaging with marrow studies has 90% accuracy in diagnosing osteomyelitis. [26] Diagnosis of osteomyelitis is often based on radiologic results showing a lytic center with a ring of sclerosis. [13]
Gallium scan showing panda (A) and lambda (B) patterns, considered specific for sarcoidosis in the absence of histological confirmation. In the past, the gallium scan was the gold standard for lymphoma staging, until it was replaced by positron emission tomography (PET) using 18 F-fluorodeoxyglucose (FDG).
A bone scan or bone scintigraphy / s ɪ n ˈ t ɪ ɡ r ə f i / is a nuclear medicine imaging technique used to help diagnose and assess different bone diseases. These include cancer of the bone or metastasis, location of bone inflammation and fractures (that may not be visible in traditional X-ray images), and bone infection (osteomyelitis).
It is often difficult to differentiate osteomyelitis from a Charcot joint, as they may have similar tagged WBC scan and MRI features (joint destruction, dislocation, edema). Definitive diagnosis may require bone or synovial biopsy.
Indium-111 (111 In) is a radioactive isotope of indium (In). It decays by electron capture to stable cadmium-111 with a half-life of 2.8 days. [3] Indium-111 chloride (111 InCl) solution is produced by proton irradiation of a cadmium target (112 Cd(p,2n) or 111 Cd(p,n)) in a cyclotron, as recommended by International Atomic Energy Agency (IAEA). [4]
Laboratory testing includes white blood cell count, ESR and CRP. These values are usually elevated in those with septic arthritis; however, these can be elevated by other infections or inflammatory conditions and are, therefore, nonspecific. [2] [11] Procalcitonin may be more useful than CRP. [28]
The white blood cell differential is a common blood test that is often ordered alongside a complete blood count.The test may be performed as part of a routine medical examination; to investigate certain symptoms, particularly those suggestive of infection or hematological disorders; [5] [6] or to monitor existing conditions, such as blood disorders and inflammatory diseases.