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Vol. 38. Issue 6.
Pages 397-407 (November - December 2019)
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Vol. 38. Issue 6.
Pages 397-407 (November - December 2019)
Continuing Education
Role of Nuclear Medicine in the diagnosis of musculoskeletal infection: a review
Revisión del papel de la Medicina Nuclear en el diagnóstico de la infección musculoesquelética
E. Noriega-Álvareza,b,
Corresponding author

Corresponding author.
, L. Domínguez Gadeab,c, M.P. Orduña Diezb,d, V. Peiró Valgañónb,e, S. Sanz Viedmab,f, R. García Jiménezb,g
a Nuclear Medicine Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
b SEMNIM Musculoskeletal Pathology Task Group, Spain
c Nuclear Medicine Department, Hospital Universitario La Paz, Madrid, Spain
d Nuclear Medicine Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
e Image diagnosis, Hospital Universitario de Fuenlabrada, Madrid, Spain
f Nuclear Medicine Department, Hospital Universitario Virgen de la Victoria, Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
g Nuclear Medicine Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Tables (3)
Table 1. Uses of acquisition with corrected decay time in images acquired with scintigraphy with leukocytes labeled with 99mTc-HMPAO.
Table 2. Patterns of interpretation in 18F-FDG PET/CT for the diagnosis of aseptic loosening or infection in hip prosthesis.
Table 3. 18F-FDG PET/CT in the evaluation of response to treatment of spondylodiscitis.
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Inflammatory and infectious osteoarticular diseases can cause serious consequences for the patient if they are not diagnosed on time. In the last decades, different modalities of nuclear medicine have allowed to study the physiopathology of these processes, and nowadays, they play an important role in diagnosis, characterization and monitoring of musculoskeletal infectious diseases. Therefore, it is essential that every nuclear medicine physician have a vision of the advantages and disadvantages of each method and know how to use them correctly in the diagnosis of the patient. This article highlights the role of nuclear medicine in standardizing the diagnostic approach in patients with infectious/inflammatory diseases, in particular in peripheral osteomyelitis, septic arthritis, prosthetic joint infections, infected diabetic foot and spinal infections. The authors reveal the role of the most common radionuclides tests, with their advantages and clinical indications, to achieve an adequate diagnosis of infection and inflammation.

Musculoskeletal infection
Bone scan
Diabetic foot
Prosthetic bone infection
Septic arthritis

Las enfermedades inflamatorias e infecciosas osteoarticulares pueden tener graves consecuencias para el paciente si no se diagnostican a tiempo. En las últimas décadas, diferentes modalidades de la Medicina Nuclear han permitido estudiar la fisiopatología de estos procesos y desempeñan un importante papel hoy en día en el diagnóstico, caracterización y monitorización de las enfermedades infecciosas musculoesqueléticas. Por lo tanto, es esencial que todos los especialistas de Medicina Nuclear tengan una visión de las ventajas y desventajas de cada método y saber cómo usarlos correctamente en el diagnóstico del paciente. Este artículo destaca el papel de la Medicina Nuclear en la estandarización del abordaje diagnóstico en pacientes con enfermedades infecciosas/inflamatorias, en particular en osteomielitis periférica, artritis séptica, infecciones de prótesis articulares, pie diabético infectado e infecciones de la columna vertebral. Los autores presentan las pruebas con radionúclidos más comunes, con sus ventajas e indicaciones clínicas, para lograr un diagnóstico adecuado de la infección y la inflamación.

Palabras clave:
Infección musculoesquelética
Gammagrafía ósea
Pie diabético
Infección de prótesis ósea
Artritis séptica


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