Combined Techniques of Non-invasive 99mTcBesilesomab/ 99mTc-Sulfur Colloid with Hybrid SPECT/CT Imaging in Characterising Cellulitis from Symptomatic Perimegaprosthetic Infection: A Case Report
https://doi.org/10.5704/MOJ.2011.032
- Author:
Tagiling N
1
;
Mohd-Rohani MF
2
;
Wan-Sohaimi WF
1
;
Faisham W
3
;
Nawi NM
1
Author Information
1. Department of Nuclear Medicine, Radiotherapy and Oncology, Universiti Sains Malaysia, Kubang Kerian, Malaysia
2. Nuclear Medicine Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
3. Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia
- Publication Type:Journal Article
- Keywords:
megaprosthesis, periprosthetic infection, nuclear medicine, single-photon emission computed tomography/computed tomography, radiopharmaceuticals
- From:Malaysian Orthopaedic Journal
2020;14(No.3):188-193
- CountryMalaysia
- Language:English
-
Abstract:
Megaprosthesis is used to restore the form and function of
massive skeletal defects, but it is accompanied by risks of
failure, mainly due to perimegaprosthetic infection (PMI). In
practice, the diagnosis of infected megaprosthesis among
patients with a high index of clinical suspicion, elevated
serological markers, and multiple negative or inconclusive
imaging can be very challenging and poses a diagnostic
conundrum to many orthopaedic surgeons. We present the
case of a symptomatic 26-year-old female with large B-cell
lymphoma who developed cellulitis with suspected
complication of PMI 15 months post-implantation. The
combination of advanced nuclear medicine imaging
strategies, i.e., 99mTc-besilesomab/
99mTc-sulfur colloid
scintigraphy with hybrid single-photon emission computed
tomography/computed tomography (SPECT/CT) scanning
helps to characterise and delineate both infections. Invasive
procedures such as joint aspiration and biopsy were avoided,
and the patient was successfully treated with antibiotics.
Hence, we report a case where advanced imaging modalities
were decisive in the investigation of PMI.
- Full text:16.2020my1133.pdf
