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CC BY-NC-ND 4.0 · World J Nucl Med 2017; 16(02): 160-162
DOI: 10.4103/1450-1147.203067
Case report

Acute hematogenous osteomyelitis presenting as a “Cold” rib in a child

Michael Annen
Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA
,
Mickaila Johnston
Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA
,
Joe Gormley
Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA
,
Eugene Silverman
Department of Radiology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA
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A “cold” defect or an area of decreased radiotracer deposition is the less common appearance of acute hematogenous osteomyelitis (AHO) on a Tc99 m-methylene disphosphonate (Tc99 m-MDP) bone scan. Group A beta-hemolytic Streptococcus (GABHS) is a significantly less common cause of AHO than Staphylococcus aureus, particularly when the infection involves the pelvis or flat bones such as the ribs. Here, we present a case report of isolated acute “cold” hematogenous osteomyelitis in a rib of a child with GABHS bacteremia that was detected on 99Tc-MDP bone scan, with magnetic resonance imaging correlation, and pathologic confirmation after rib resection.

Disclaimer: The views expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Department of Navy, Department of Defense, or the U.S. Government.

Keywords

Bone scan - cold - Group A beta-hemolytic Streptococcus - osteomyelitis - photopenic - Tc99 m.methylene disphosphonate


Publication History

Article published online:
18 May 2022

© 2017. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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