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Technetium bone scintigraphy in the diagnosis of osteomyelitis in children

In a 5 1/2-year retrospective study of hospitalized children with osteomyelitis who had technetium bone scans, we found that 32 of 38 (84%) had increased radionuclide uptake, 4 (11%) had normal uptake and 2 (5%) had decreased uptake. The two patients with decreased uptake had a stormy course with extensive bone destruction and pathologic fractures in spite of prolonged courses of antibiotic therapy. Decreased uptake on bone scan in patients with clinical evidence of osteomyelitis could indicate a poor prognosis and early surgical drainage is indicated in order to decrease morbidity.