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KMID : 0381219780100010021
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Journal of RIMSK
1978 Volume.10 No. 1 p.21 ~ p.34
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A Study on the Bone Scanning in Experimental Staphylococcal Osteomyelitis
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Abstract
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Until recently the standard bone scanning isotopes were 85Sr, 87mSr, and 18F, but none of these isotopes were entirely satisfactory. Recently technetium 99m labeled phosphate compounds which combined a high affinity for bone and rapid renal excretion with the convenience and ideal physical properties of technetinm 99m (99* Tc) was introduced by Subramanian.
The 99* Tc diphosphonate seems to be the best technetium 99m labeled phosphate compound and the 99*Tc diphosphonate bone scan has become a sensitive, reliable and safe method for evaluating diseases of bone.
The inflammatory disease of bone are still frequent in spite of excellent antibiotics. The early diagnosis of these disease is a problem, because of nonspecific clinical findings in early stage. Raciographic examination is not sufficiently reliable in early detection because an abnormality is unlikely to be observed until more than 50% of the bone material has been lost. The bone scan may become positive earlier than renogenologic study.
To test the possibility that bone scanning could be used for early detection of the disease, 30 young adult rabbits were inoculated with Staphylococcus aureus at right proximal tibias and induced experimental staphylococcal osteomyelitis in 19 rabbits. 4 rabbits were sacrificed at serial intervals, between 2 days to 28 days, and then bacteriologic, pathologic, conventional roentgenologic study and bone scanning were carried out and following results were obtained.
1. In cases which were sacrificed on the 8th day after inoculation, bone scanning revealed significant high uptake "hot" area and radio-graphic examination did not revealed any abnorrnal findings.
2. In cases which were sacrificed on, the 20th day both of bone scanning and radiographic examination revealed osteomyelitis findings.
3. In pathologic studies, inflammatory cells in filtration and microabscess were major findings
in the cases which sacificed on the 2nd and 5th day. After the 8th day, subperiosteal new bone formation with massive fibrosis and abscess formation were increased.
4. In 19 cases which revealed osteomyelitis in pathologic study, positive staphylocoual cultures of aspirated materials from proximal tibia were obtained in 17 rabbits. Positive staphylococcal culture of aspirated material from distal tibia was obtained in one rabbit which sacrficed on the 28th day after inoculation.
5. The "hot" areas in bone scanning were correlated to new bone formation in all experimeital
osteomyelitis cases.
6. The bone scan seems to be helpful for the early diagnosis of osteomyelitis, because the scan revealed "hot" area earlier than roentgenologic study.
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