From the *Nuclear Medicine, Spedali Civili Brescia; and †Nuclear Medicine, University of Brescia, Brescia, Italy.
Clin Nucl Med. 2016 Jun;41(6):e298-300. doi: 10.1097/RLU.0000000000001217.
Diagnosing prosthetic joint infection is difficult; clinical signs and symptoms, laboratory tests, radiography, and joint aspiration are less sensitive and specific. We report a patient with fever and painful bilateral hip prosthesis, who underwent Tc-sulesomab scan showing moderate tracer uptake at the lateral surface of the right thigh and no signs of prosthesis infection. The F-FDG-PET/CT showed high uptake at the soft tissue of the right hip prosthesis and detected a fistula. Moreover PET/CT discovered an initial bone marrow involvement at the right femur. The subsequent fistulography confirmed the fistula, and the patient underwent definitive fistulotomy successfully.
诊断人工关节感染较为困难;临床体征和症状、实验室检查、影像学检查和关节穿刺术均不够敏感和特异。我们报告 1 例发热伴双侧人工髋关节置换术后疼痛的患者,Tc-sulesomab 扫描显示右侧大腿外侧有中度示踪剂摄取,但无假体感染的迹象。F-FDG-PET/CT 显示右侧髋关节假体软组织摄取增高,并发现瘘管。此外,PET/CT 还发现右侧股骨初始骨髓受累。随后的瘘管造影证实了瘘管的存在,患者成功接受了确定性瘘管切开术。