SCINTIGRAPHY AND ULTRASONOGRAPHY IN DIFFERENTIATING OSTEOMYELITIS FROM BONE INFARCTION IN SICKLE-CELL DISEASE

Purpose: To demonstrate the combined use of scintigraphy and ultrasono graphy (US) in differentiating osteomyelitis from bone infarction in s ickle cell disease. Material and Methods: Two patients with sickle cel l disease were examined with a combination of bone, bone marrow, white blood cell and/or gallium scintigraphy and US. Results: The scintigra phic studies demonstrated areas of suspected osteomyelitis at the dist al femur in both patients and at the proximal right tibia in one of th em. US revealed subperiosteal fluid collections in these areas. Aspira tion guided by US established the presence of pus at the femur in both instances, which was successfully treated with the US-guided insertio n of a drainage catheter and aspiration only, respectively. Thick bloo d, due to bone infarction, was aspirated at the tibia. Conclusion: The scintigraphic studies were useful in locating all areas of suspected osteomyelitis. The role of US was to confirm the presence of a subperi osteal fluid collection and to guide aspiration, which can show the di stinction between a haematoma and an abscess.