[Sensitivity and specificity of the Tc-99m ciprofloxacin scan in pediatric osteomyelitis].

INTRODUCTION: The Tc-99m-ciprofloxacin complex, introduced in 1993, has been extensively evaluated all over the world with good results for the diagnosis of active bacterial osteoarticular infections. There are only a few publications on the use of this procedure in pediatric ages. In our study we evaluated the efficacy of the Tc-99m ciprofloxacin scan for the diagnosis of osteoarticular infections in the pediatric population assessing its sensitivity, specificity, and positive and negative predictive value.

MATERIAL AND METHODS: A retrospective, descriptive, observational study was done in 94 patients with clinical suspicion of osteoarticular infection in whom a Tc-99m ciprofloxacin bone scan was performed; the diagnosis was confirmed with intraoperative cultures and blood cultures. The results obtained with the Tc-99m ciprofloxacin scan and the culture reports were analyzed, as well as the sensitivity, specificity and the positive and negative predictive values of the Tc-99m ciprofloxacin scan.

RESULTS: Among the patients with intraoperative and blood cultures, 80 cases (85.1%) were positive and 14 cases (14.9%) were negative for bone infection. In the Tc-99m ciprofloxacin scan 78 cases (83%) were found to be positive for infection and 16 cases (17%) were negative. There were two false negatives. We found a 97.6% sensitivity and 100% specificity, with a 100% positive predictive value and an 87.5% negative predictive value.

CONCLUSION: The Tc-99m-ciprofloxacin complex is useful to make the differential diagnosis between inflammation and infection in pediatric patients in whom an osteoarticular infectious process is suspected.