Technetium-99-labeled leukocytes in diagnosing diabetic osteomyelitis in the foot

J Foot Ankle Surg. 1997 May-Jun;36(3):209-14; discussion 256. doi: 10.1016/s1067-2516(97)80117-2.


Hexamethylpropylamineoxine (HMPAO)-labeled leukocytes were studied to examine the scintigraphic significance of the procedure in diagnosing bone infection in patients with chronic nonhealing foot ulcerations. Fifty-two patients were scanned with Technetium-99-labeled white blood cells and scintigraphic results were compared with histological analysis, bone culture, and radiographic findings. Twenty-one patients demonstrated positive uptake with imaging and focal accumulation of leukocytes at the area of suspected infection. Sensitivity, specificity, and accuracy were calculated and found to be 86%, 90%, and 88%, respectively. Thirty-one members of the population were also scanned with Tc-99 methylene diphosphate (MDP) triphasic scintigraphy. Sensitivity equaled 91% and specificity was found to be significantly lower (40%) when compared with the leukocyte-labeled scans. Technetium-99 (HMPAO) leukocyte scintigraphs demonstrated a significantly higher specificity and accuracy rate when compared with Technetium-99 (MDP) triphasic scans.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Diabetic Foot / complications*
  • Diabetic Foot / diagnostic imaging
  • Gallium Radioisotopes
  • Humans
  • Indium Radioisotopes
  • Isotope Labeling
  • Leukocytes*
  • Male
  • Middle Aged
  • Organotechnetium Compounds*
  • Osteomyelitis / diagnostic imaging*
  • Osteomyelitis / etiology
  • Oximes*
  • Radionuclide Imaging
  • Retrospective Studies
  • Sensitivity and Specificity
  • Technetium Tc 99m Exametazime


  • Gallium Radioisotopes
  • Indium Radioisotopes
  • Organotechnetium Compounds
  • Oximes
  • Technetium Tc 99m Exametazime