Radionuclide Imaging of Musculoskeletal Infection

A look at the various radiopharmaceuticals used in the diagnostic workup of patients suspected of having musculoskeletal infection.

Course ID: Q00492 Category:
Modalities: ,


Satisfaction Guarantee


Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 14, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 0.25
Procedures: 0.25
Head, Spine, and Musculoskeletal: 0.25

Magnetic Resonance Imaging: 0.25
Procedures: 0.25
Musculoskeletal: 0.25

Nuclear Medicine Technology: 1.50
Procedures: 1.50
Other Imaging Procedures: 1.50

Radiography: 0.25
Procedures: 0.25
Extremity Procedures: 0.25

Registered Radiologist Assistant: 0.75
Procedures: 0.75
Musculoskeletal and Endocrine Sections: 0.75

Sonography: 0.25
Procedures: 0.25
Superficial Structures and Other Sonographic Procedures: 0.25


  1. Introduction
  2. Morphologic Imaging
    1. Radiography
    2. MRI
    3. CT and Ultrasonography
  3. Radionuclide Imaging
    1. Bone Scintigraphy
    2. 67Ga Scintigraphy
    3. Labeled Leukocyte Scintigraphy
    4. 111In-Biotin
    5. Radiolabeled Antiobiotics
    6. Radiolabeled Antimicrobial Peptides
    7. 18F-FTG
    8. 18F-FDG-Labeled Leukocytes
    9. 68Ga-Citrate
    10. 124I-Fialuridine
  4. Indications
    1. Spondylodiskitis
    2. Diabetic Pedal Osteomyelitis
    3. Prosthetic Joint Infection
  5. Conclusion


Upon completion of this course, students will:

  1. identify the systemic risk factors for acute osteomyelitis
  2. be familiar with the morphological imaging tests used when suspecting osteomyelitis
  3. identify the radiopharmaceutical used for bone scintigraphy
  4. be familiar with the appearance of osteomyelitis on a bone scan
  5. be familiar with the mechanism of localization of infection with 67Ga
  6. identify the radionuclides used to label leukocytes in vitro
  7. be familiar with the labeling of leukocytes with radionuclides
  8. be familiar with the normal distribution of 99mTc-labeled leukocyte scan
  9. identify the radiopharmaceutical used to differentiate infection and marrow
  10. identify the in vivo labeled leukocyte imaging agents
  11. identify the radiolabeled antimicrobial peptide used for infection imaging
  12. be familiar with the categories of musculoskeletal infections
  13. be familiar with hematogenously pyogenic spondylodiskitis
  14. be familiar with the adjunct role of radionuclide imaging in spondylodiskitis
  15. be familiar with the advantages of 67Ga SPECT/CT in spondylodiskitis
  16. identify radiopharmaceuticals that are useful for diagnosing spondylodiskitis
  17. be familiar with the advantages of using SPECT/CT in spondylodiskitis
  18. be familiar with the advantages of using 18F-FDG for low grade spondylodiskitis
  19. be familiar with the superiority of 18F-FDG for localizing sites of infection and guiding minimally invasive surgery
  20. be familiar with the limitations of using 18F-FDG in musculoskeletal infection imaging
  21. identify the radionuclide imaging test of choice for diagnosing spondylodiskitis
  22. identify the radionuclide imaging test of choice for diagnosing diabetic pedal osteomyelitis
  23. be familiar with dual isotope techniques used for diagnosing suspected pedal osteomyelitis
  24. be familiar with the development of a Composite Severity Index for 99mTc-labeled leukocyte SPECT/CT
  25. be familiar with the use of 99mTc-labeled leukocyte SPECT/CT to monitor treatment response in diabetics with pedal osteomyelitis
  26. identify the most common cause of prosthetic joint failure
  27. identify which imaging modality has become the preeminent evaluation for joint arthroplasty infection
  28. be familiar with the radionuclide imaging tests that are best suited for evaluation of joint arthroplasty infection
  29. be familiar with the pooled sensitivity and specificity of 18F-FDG PET and PET/CT for lower extremity prosthetic joint infection
  30. be familiar with the hybrid imaging techniques that are redefining the role of radionuclide imaging in patients with musculoskeletal infections