- Discussion:
- if suspected osteomyelitis is superimposed on a disease that causes increased bone remodeling, the combined Indium-111-labeled
leukocyte-Technetium-99m bone scan is the procedure of choice in non-marrow-containing skeleton and the Indium-111-labeled leukocyte
and Technetium-99m bone marrow scans are the procedures of choice in marrow-containing skeleton.
- indium WBC preparations require withdrawing approx 50 ml of autologous blood with a leukocyte count of approximately 5,000 per ml;
- leukocytes are collected by centerfuge, exposed to Indium, and re-injected IV;
- images obtained at 24 hours show activity only in the liver, spleen, & bone marrow; - most studies are taken at 24 hrs;
- normal healing wounds and fully treated infections with no significant degree of inflammation show no disernable uptake;
- providing IV antibiotics does not affect the test;
- false positive: IM injection sites, non-infected fracture, total joint prosthesis, and rheumatoid arthritis;
- overlying soft tissue infection may also cause false positive