ABSTRACT
AIM: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). METHODS: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. RESULTS: CRP was the most effective serum parameter for follow-up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. CONCLUSION: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.
Subject(s)
Bacterial Infections/epidemiology , Bone and Bones/diagnostic imaging , Osteomyelitis/blood , Osteomyelitis/diagnostic imaging , Anti-Bacterial Agents/therapeutic use , Biomarkers/blood , Blood Sedimentation , C-Reactive Protein/analysis , Female , Follow-Up Studies , Humans , Infant , Leukocyte Count , Male , Osteomyelitis/drug therapy , Radiography , Radionuclide Imaging , Recurrence , Retrospective Studies , Time FactorsABSTRACT
This paper describes a method for SPET quality control that facilitates the determination of COR-offset, parallel y-shift and detector tilt by means of a single, comprehensive test using a special phantom consisting of three point sources. The evaluation of the method was performed by a series of measurements utilizing manually adjusted detector tilts and a simulation of y-shift by moving the phantom. The results show that y-shift and detector tilt are measured with reasonable accuracy, and that y-shift caused by variations in detector tilt can be differentiated from y-shift caused by other factors.