Images in Paediatrics
Osteomyelitis detected by 18F-FDG PET-CT
Osteomielitis detectada por 18F-FDG PET-TC
Alberto Martinez-Lorca
, Odile Ajuria-Illarramendi, Maria del Prado Orduña-Diez
Corresponding author
Servicio de Medicina Nuclear, Hospital Universitario Ramón y Cajal, Madrid, Spain
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"idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Osteomyelitis detected by <span class="elsevierStyleSup">18</span>F-FDG PET-CT" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "390" "paginaFinal" => "391" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alberto Martinez-Lorca, Odile Ajuria-Illarramendi, Maria del Prado Orduña-Diez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Alberto" "apellidos" => "Martinez-Lorca" "email" => array:2 [ 0 => "albertoml85@yahoo.es" 1 => "amlorca@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Odile" "apellidos" => "Ajuria-Illarramendi" ] 2 => array:2 [ "nombre" => "Maria del Prado" "apellidos" => "Orduña-Diez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Nuclear, Hospital Universitario Ramón y Cajal, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteomielitis detectada por <span class="elsevierStyleSup">18</span>F-FDG PET-TC" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 620 "Ancho" => 1674 "Tamanyo" => 67500 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Maximum intensity projection image. (B) Coronal CT image. (C) Coronal PET image. (D) Coronal PET/CT fusion image: <span class="elsevierStyleSup">18</span>F-FDG imaging with high uptake in the proximal epiphysis of the right humerus (blue arrow) associated with active osteomyelitis<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and moderate uptake in the articular surface of the right humeral head associated with the already established active articular illness.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a male infant aged 16 days with an unremarkable maternal obstetric history, born at 38 + 6 weeks of gestation. He was admitted on account of 2 febrile temperature peaks of 38 °<span class="elsevierStyleSmallCaps">C</span> and pain on mobilization of the right shoulder. After an ultrasound examination detected arthritis in the right shoulder, culture of surgical specimens confirmed the presence of <span class="elsevierStyleItalic">Staphylococcus aureus</span>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Given the worsening symptoms and with the aim of assessing for the potential presence of additional foci of infection, a whole-body positron-emission tomography (PET)/computed tomography (CT) scan was performed (Biograph™ mCT 20 scanner, Siemens Medical Systems; Knoxville, TN, USA), including the extremities (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), with an administered activity of 36.8 MBq/0.99 mCi of <span class="elsevierStyleSup">18</span>F-fluorodeoxyglucose (<span class="elsevierStyleSup">18</span>F-FDG) (paediatric dose recommended by the European Association of Nuclear Medicine)<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and low-dose CT-based attenuation correction (80 kVp, 5 mAs).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Acute osteomyelitis, a rare complication in newborn infants, poses a diagnostic and therapeutic challenge.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The value of <span class="elsevierStyleSup">18</span>F-FDG PET-CT in paediatric oncology is well established, although in children with fever or suspected infection, the evidence on the usefulness of <span class="elsevierStyleSup">18</span>FDG PET-CT imaging is scarce, despite its proven usefulness in the diagnosis of infectious or inflammatory foci in adult patients.</p><p id="par0020" class="elsevierStylePara elsevierViewall">If there is uncertainty in the suspicion of infection and/or inflammation of synovial joints, the use of <span class="elsevierStyleSup">18</span>F-FDG PET-CT imaging could be contemplated in very select cases for the accurate assessment of septic arthritis with underlying acute osteomyelitis.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 620 "Ancho" => 1674 "Tamanyo" => 67500 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Maximum intensity projection image. (B) Coronal CT image. (C) Coronal PET image. (D) Coronal PET/CT fusion image: <span class="elsevierStyleSup">18</span>F-FDG imaging with high uptake in the proximal epiphysis of the right humerus (blue arrow) associated with active osteomyelitis<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and moderate uptake in the articular surface of the right humeral head associated with the already established active articular illness.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Stauss" 1 => "C. Franzius" 2 => "T. Pfluger" 3 => "K.U. Juergens" 4 => "L. Biassoni" 5 => "L. Begent" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00259-008-0826-x" "Revista" => array:6 [ "tituloSerie" => "Eur J Nucl Med Mol Imaging" "fecha" => "2008" "volumen" => "35" "paginaInicial" => "1581" "paginaFinal" => "1588" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18536914" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of FDG-PET/CT in children with fever of unknown origin" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. Pijl" 1 => "T.C. Kwee" 2 => "G.E. Legger" 3 => "H.J. Peters" 4 => "W. Armbrust" 5 => "E.H. 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St Geme 3rd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2017151929" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2017" "volumen" => "283" "paginaInicial" => "629" "paginaFinal" => "643" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28514223" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000010000000005/v1_202405192134/S2341287924001212/v1_202405192134/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000010000000005/v1_202405192134/S2341287924001212/v1_202405192134/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287924001212?idApp=UINPBA00005H" ]
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