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False-Normal Radionuclide Scans for Osteomyelitis

JOE C. LEONARD, MD; MELVIN I. MARKS, MD; EMANUAL KOLYVAS, MD
Am J Dis Child. 1981;135(4):383. doi:10.1001/archpedi.1981.02130280073030.
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Sir.—The article by Fleisher et al (Journal 1980;134:499-502) presents, we presume, a very small portion of the bone scans performed by them in the search for osteomyelitis.

The cases presented may in fact have been false-normal, but based on the illustrations we find that conclusion very difficult to reach. Figure 1, left, demonstrates a definite asymmetry in sacroiliac joint uptake, although the image is not labeled adequately to permit determination of which is the left side. Figure 2, left, is inadequate, as the entire pelvis is obscured by the bladder and the left femoral head may in fact have greater isotope localization, if it is an anterior view.

The significance of a normal bone scan in patient 3 is that it may have been correct. A needle biopsy of the area in question three days later revealed no evidence of infection. Is it possible that the Salmonella septicemia was

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