Pediatric Osteomyelitis: A Scintigraphic Review

This review presents techniques to optimize bone scintigraphy for evaluation of a spectrum of abnormalities associated with pediatric osteomyelitis.

Course ID: Q00343 Category:
Modalities: ,


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:

Nuclear Medicine Technology: 2.50
Procedures: 2.50
Other Imaging Procedures: 2.50

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Musculoskeletal and Endocrine Sections: 2.50


  1. Introduction
  2. Imaging Modalities
  3. Scintigraphic Protocol
  4. Special Pediatric Considerations
  5. Pathophysiology
  6. Neonates
  7. Differential Diagnosis
  8. Conclusions


Upon completion of this course, students will:

  1. identify the most common source for osteomyelitis
  2. be familiar with the routes of infection for osteomyelitis
  3. identify the most common route of infection for osteomyelitis
  4. be familiar with the first imaging assessment performed for osteomyelitis
  5. identify which imaging modality is more suited for soft-tissue changes associated with osteomyelitis
  6. understand the advantages of MRI for osteomyelitis
  7. identify the imaging modalities that are not used for screening osteomyelitis
  8. understand the advantages of using bone scintigraphy for osteomyelitis
  9. be familiar with the time frame for osteomyelitis to appear on bone scintigraphy
  10. understand when to use MRI as the imaging modality for suspected osteomyelitis
  11. identify the goal of treatment for patients suffering from osteomyelitis
  12. be familiar with the traditional delivery of antibiotics to treat osteomyelitis
  13. identify what radiopharmaceutical is used for bone scintigraphy
  14. be familiar with the first phase of the triple-phase bone scintigraphy
  15. recognize which phase of triple-phase bone scintigraphy is definitive
  16. understand the role of whole-body imaging for osteomyelitis
  17. be familiar with the radiopharmaceutical uptake of diphosphonates
  18. understand the role of white blood cell scintigraphy
  19. be familiar with hydroxyapatite crystals
  20. understand the localization of bone radiopharmaceuticals in the human body
  21. be familiar with alternatives to 99mTc MDP for bone scintigraphy
  22. identify what test is used to determine quality control on 99mTc MDP
  23. recognize drugs that can alter biodistribution of bone imaging agents
  24. be familiar with radiopharmaceuticals used for PET bone scans
  25. be familiar with the dose administration to imaging time for a PET bone scan
  26. be familiar with the methods for calculating pediatric radiopharmaceutical doses
  27. understand who determines the need for sedation
  28. be familiar with the organization that provides guidelines for pediatric sedation
  29. be familiar with the organization that exists to minimize pediatric radiation exposure
  30. understand how osteomyelitis begins in pediatric patients’ long bones
  31. understand why microorganisms may grow in the metaphyseal capillaries
  32. be familiar with the characteristics of Brodie abscess
  33. identify the most common bacterial pathogenic cause for osteomyelitis
  34. be familiar with the clinical signs of osteomyelitis in neonates
  35. be familiar with the location of septic arthritis in children younger than 1 year of age