No abstract available.
Osteomyelitis* ; Radionuclide Imaging*

Acute osteomyelitis is usually shown as a localized area of increased activity (hot uptake) in the infectious focus on bone scintigraphy. In our patient, absence of radioactivity (cold lesion) was noted in the distal metaphyseal and diaphyseal regions of his right femur. Initial x-ray was interpreted as normal except for mild soft tissue swelling in the right thigh. The lesion was confirmed as an acute osteomyelitis with subperiosteal abscess on surgery. Staphylococcus aureus was the etiologic organism. We describe a case of acute osteomyelitis in a one-year-old boy shown as a cold lesion on bone scan.
Abscess ; Femur ; Humans ; Male ; Osteomyelitis* ; Radioactivity ; Radionuclide Imaging ; Staphylococcus aureus ; Technetium Tc 99m Medronate ; Thigh

Bone imagings have played important role in early detection of acute osteomyelitis. In acute osteomylitis, bone scan findings precede the appearance of bone change on radiograph. Also, recent studies have reported accuracies of bone scan in diagnosis of osteomyelitis ranging from 84% to 100%. But, in above datas, bone scan reading were only qualitative studies. So we have reviewed Technetium-99m labelled methylen dipho sphonate(99mTc-MDP) scan on 21 patients who had been diagnosed acute osteomyelitis by clinical symptoms, blood culture, pus culture and operative findings from January, 1984 to September, 1985. The purpose of this study is to establish the quantitative study of bone scan using computed pixel counting method. The 21 cases were classified into group I and group II according to initial radiographic findihgs. The group I showed normal radiographic finding or soft tissue swelling without osseous change. The group II showed osseous change. The results obtained were as follows: 1. We obtained positive bone scans in the all cases which were confirmed acute osteomyelitis. 2. We experienced diagnosis of acute osteomyelitis by bone scan which was confirmed as early as 48 hours after onset of clinical symptom. 3, In group I, the average uptake ratio of 99mTc-MDP was 3.22±0.82 ranging from 2.20 to 4.80. 4. In group II, the average uptake ratio of 99mTc-MDT was 6.20±2.27 ranging from 4.00 to 9.40. (p <0.001).
Diagnosis ; Early Diagnosis ; Humans ; Methods ; Osteomyelitis ; Radionuclide Imaging ; Suppuration ; Technetium Tc 99m Medronate

To evaluate the usefulness of MR in the osteomyelitis, we reviewed MR examinations of 14 patients with pyogenic osteomyelitis of the long bone. All 14 patients were confirmed to have osteomyelitis either surgically (13/14) or by aspiration (1/14). MRI was performed with 0.5R (n=8) or 2.0T (n=6) SE technique, and Gd-DTPA enhanced T1WI was obtained in 10 examinations. Anatomic location of lesions were femur (8/14), tibia (5/14),m and fibula (1/14). The marrow cavity and soft tissue were involved in 13/14, 12/14 respectively. The signals of both intraosseous and extraosseous infected area were iso to low signal intensity to muscles on T1WI and high signal intensity on PDWI & T2WI. Rim or diffuse enhancement of the marrow cavity and soft tissue were seen in all (10/10) cases. Sequestra, periosteal reaction. And cortical defect were found in 12/14, 10/14, 9/14. MR provided more accurate and detailed anatomic information including extent of disease and possible activity than bone scintigraphy, CT, or conventional radiography. We conclude that MR might be the choice of modality in the diagnosis of osteomyelitis of the long bone.
Bone Marrow ; Diagnosis ; Femur ; Fibula ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Muscles ; Osteomyelitis* ; Radiography ; Radionuclide Imaging ; Tibia

It is known that cases of osteomyelitis are less common than 5% in deep burn cases. This research presents a case of chronic osteomyelitis, presented 7 years after initial electrical burn injury. A 43-year-old male patient was admitted to the Department of Plastic Surgery, suffering from an 22900-voltage electrical burn on right medial malleolus in 2010. There was no postoperative complication for five years observation. In November 2016, he was admitted to the Plastic Surgery department, suffering from the skin and soft tissue defect on right medial malleolus without trauma history. The osteomyelitis on the right medial malleolus was found in bone scintigraphy. The medial malleolus was covered with a local flap two days after admission. Dehiscence was found after surgery and exudate was emerged continuously from the flap site. We decided to cover the raw surface with a perforator based propeller flap 22 days after admission considering reconstructive ladder. The flap survived successfully, and partial epidermal sloughing was healed completely by daily dressing at 51 days after the surgery. It is advisable to establish and access the prudent plan before surgery through many kinds of radiological tests and physical examinations considering vascular stability and delayed wound healing.
Adult ; Bandages ; Burns* ; Exudates and Transudates ; Humans ; Male ; Osteomyelitis* ; Physical Examination ; Postoperative Complications ; Radionuclide Imaging ; Skin ; Surgery, Plastic ; Wound Healing

osteomyelitis developed in the mandible in a 37-year-old woman during endodontic treatment. Endodontic treatment was performed using a paraformaldehyde-containing material. One month later, extensive bone necrosis was developed in the alveolar bone and adjacent teeth. Bone scintigraphy and radiographic findings showed the presence of a definite bony lesion in the right mandible. So acute suppurative osteomyelitis was diagnosed. The patient was treated by the extraction of the affected teeth and the removal of necrotic bone under general anesthesia. She recovered normally after 2 weeks of antibiotics treatment. Such a case of suppurative osteomyelitis developing during a relatively short period of endodontic treatment is very rare. We believe that the patient developed osteomyelitis due to toxicity coming from chemicals used during the endodontic treatment. Thus, we report this case and present a literature study on several drugs that can induce toxicity and complications among dental materials presently used in dentistry.]]>
Adult ; Anesthesia, General ; Anti-Bacterial Agents ; Dental Materials ; Dentistry ; Female ; Humans ; Mandible ; Necrosis ; Osteomyelitis ; Radionuclide Imaging ; Root Canal Irrigants ; Tooth

Antimicrobial agents played a miraculous role in the treatment of bacterial infections until resistant bacteria became widespread. Besides antimicrobial-resistant bacteria, many factors can influence the cure of infection. Nocardia infection may be a good example which is difficult to cure with antimicrobial agents alone. A 66-year-old man developed soft tissue infection of the right buttock and thigh. He was given prednisolone and azathioprine for pachymeningitis 3 months prior to admission. Despite surgical and antimicrobial treatment (sulfamethoxazole-trimethoprim), the infection spread to the femur and osteomyelitis developed. The case showed that treatment of bacterial infection is not always as successful as was once thought because recent isolates of bacteria are more often resistant to various antimicrobial agents, intracellular parasites are difficult to eliminate even with the active drug in vitro, and infections in some sites such as bone are refractory to treatment especially when the patient is in a compromised state. In conclusion, for the treatment of infections, clinicians need to rely on laboratory tests more than before and have to consider the influence of various host factors.
Aged ; Case Report ; Drug Resistance, Microbial/physiology ; Dura Mater/microbiology* ; Fatal Outcome ; Femur/radiography ; Human ; Male ; Meningitis/microbiology* ; Nocardia Infections/physiopathology ; Nocardia Infections/drug therapy* ; Osteomyelitis/radionuclide imaging ; Osteomyelitis/radiography ; Osteomyelitis/microbiology*

Infectious and inflammatory bone diseases include a wide range of disease process, depending on the patient's age, location of infection, various causative organisms, duration from symtom onset, accompanied fracture or prior surgery, prosthesis insertion, and underlying systemic disease such as diabetes, etc. Bone infection may induce massive destruction of bones and joints, results in functional reduction and disability. The key to successful management is early diagnosis and proper treatment. Various radionuclide imaging methods including three phase bone scan, Ga-67 scan, WBC scan, and combined imaging techniques such as bone/Ga-67 scan, WBC/bone marrow scan add complementary role to the radiologic imaging modalities including plain radiography, CT and MRI. F-18 FDG PET imaging also has recently been introduced in diagnosis of infected prosthesis and chronic active osteomyelitis. Selection of proper nuclear medicine imaging method will improve the diagnostic accuracy of infectious and inflammatory bone diseases, based on understading of pathogenesis and radiologic imaging findings.
Bone Diseases ; Bone Diseases, Infectious* ; Bone Marrow ; Diagnosis* ; Early Diagnosis ; Joints ; Magnetic Resonance Imaging ; Nuclear Medicine* ; Osteomyelitis ; Prostheses and Implants ; Radiography ; Radionuclide Imaging

ABO discrepancy refers to an inconsistency between red cell and serum typings and has various causes, including hypogammaglobulinemia. IgM deficiency is a rare disorder that may accompany several conditions such as infection and autoimmune disorders. Here, we describe a case of IgM deficiency discovered during the evaluation of an ABO discrepancy in a 16-yr-old Korean boy. ABO blood grouping showed that while his cell type was O+, serum typing detected only anti-A (3+). Anti-B was not detectable at room temperature but was graded at 1+ at 4degrees C. ABO genotyping revealed an O/O genotype. His serum IgG, IgA, and IgM concentrations were 770 mg/dL (reference range: 800-1,700 mg/dL), 244 mg/dL (reference range: 100-490 mg/dL), and 13.5 mg/dL (reference range: 50-320 mg/dL), respectively. He was diagnosed with acute osteomyelitis on the basis of clinical presentation and imaging studies. The symptoms gradually improved within 3 weeks of treatment. However, the ABO discrepancy and IgM deficiency persisted even 6 months after recovery and lymphocyte subset analysis revealed CD19+ B cell deficiency. To the best of our knowledge, IgM deficiency detected by ABO discrepancy in a patient with acute osteomyelitis has not been reported before.
ABO Blood-Group System/genetics ; Acute Disease ; Adolescent ; B-Lymphocytes/cytology/immunology/metabolism ; Bone and Bones/radionuclide imaging ; Genotype ; Humans ; Immunoglobulin A/blood ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Immunologic Deficiency Syndromes/complications/*diagnosis ; Knee/radionuclide imaging ; Magnetic Resonance Imaging ; Male ; Osteomyelitis/complications/*diagnosis ; Radiopharmaceuticals/diagnostic use

ABO discrepancy refers to an inconsistency between red cell and serum typings and has various causes, including hypogammaglobulinemia. IgM deficiency is a rare disorder that may accompany several conditions such as infection and autoimmune disorders. Here, we describe a case of IgM deficiency discovered during the evaluation of an ABO discrepancy in a 16-yr-old Korean boy. ABO blood grouping showed that while his cell type was O+, serum typing detected only anti-A (3+). Anti-B was not detectable at room temperature but was graded at 1+ at 4degrees C. ABO genotyping revealed an O/O genotype. His serum IgG, IgA, and IgM concentrations were 770 mg/dL (reference range: 800-1,700 mg/dL), 244 mg/dL (reference range: 100-490 mg/dL), and 13.5 mg/dL (reference range: 50-320 mg/dL), respectively. He was diagnosed with acute osteomyelitis on the basis of clinical presentation and imaging studies. The symptoms gradually improved within 3 weeks of treatment. However, the ABO discrepancy and IgM deficiency persisted even 6 months after recovery and lymphocyte subset analysis revealed CD19+ B cell deficiency. To the best of our knowledge, IgM deficiency detected by ABO discrepancy in a patient with acute osteomyelitis has not been reported before.
ABO Blood-Group System/genetics ; Acute Disease ; Adolescent ; B-Lymphocytes/cytology/immunology/metabolism ; Bone and Bones/radionuclide imaging ; Genotype ; Humans ; Immunoglobulin A/blood ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Immunologic Deficiency Syndromes/complications/*diagnosis ; Knee/radionuclide imaging ; Magnetic Resonance Imaging ; Male ; Osteomyelitis/complications/*diagnosis ; Radiopharmaceuticals/diagnostic use