Indium labelled white cell scan

RADIOPHARMACEUTICAL:  99mTc WBC, 600 MBq

CLINICAL INDICATION
50 year old male with ongoing sepsis secondary to septic arthritis
despite antibiotics for assessment. Bone scan suggests
osteomyelitis in the left medial cuneiform and septic arthritis in the left
tarsometatarsal joints.  

TECHNICAL PROCEDURE AND RESULTS

Planar and SPECT/CT images were performed 4 hours after intravenous
administration of 600 MBq 99mTc labelled WBC.  

Moderately increased tracer uptake is noted in the left midfoot.
Correlation with SPECT/CT demonstrates increased tracer uptake in the left
medial cuneiform and 3rd to 5th tarsometatarsal joints, similar to that seen on
the bone scan of last week.

More significant tracer uptake is now seen in the intermediate cuneiform-2nd
metatarsal joint and the base and shaft of the left 2nd metatarsal. 

Physiological uptake is noted in the liver, spleen, and bone marrow.  No
other abnormalities detected 

OVERALL IMPRESSION

The scintigraphic appearances are consistent with osteomyelitis of the left
medial cuneiform and left 2nd metatarsal shaft with septic arthritis in the
left 2nd to 5th tarsometatarsal joints.  

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