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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 2, 140-144.
doi: 10.1302/0301-620X.90B2.19436  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Diagnosis of peri-prosthetic infection at the hip using triple-phase bone scintigraphy

S. Nagoya, MD, PhD, Associate Professor1; M. Kaya, MD, PhD, Instructor1; M. Sasaki, MD, Orthopedic Surgeon1; K. Tateda, MD, Orthopedic Surgeon1; and T. Yamashita, MD, PhD, Professor, Chairman1

1 Department of Orthopedic Surgery, Sapporo Medical University, South 1 West 16 Chuo-Ku, Sapporo 060-8543, Japan.

Correspondence should be sent to Dr S. Nagoya; e-mail: nagoya{at}sapmed.ac.jp

We evaluated triple-phase bone scintigraphy in the differential diagnosis of peri-prosthetic infection in 46 patients with a total hip replacement or bipolar hemiarthroplasty who were due for revision surgery. There were 18 men and 28 women, with a mean age at operation of 64.6 years (28 to 81). We defined peri-prosthetic infection as an increased uptake of radioisotope in all the phases of triple-phase bone scintigraphy and validated these results against the histological and/or microbiology results in every case.

The positive and negative predictive values for the presence of infection were 83% and 93%, respectively. The diagnostic sensitivity was 88% and the specificity was 90%.

This study indicates that triple-phase bone scintigraphy is a useful tool in the detection of peri-prosthetic infection and offers a cost-effective method of screening.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General