Nuclear imaging in the diagnosis of the infected total joint arthroplasty

Nuclear medicine can be of great value in diagnosing infected total joint arthroplasties. Bone scintigraphy is very sensitive for the diagnosis of prosthetic infection but is nonspecific. Gallium scintigraphy has been used in conjunction with bone scintigraphy, but this approach has not proven to be as valuable as originally anticipated. Indium leukocyte scintigraphy, especially when correlated with a bone scan and, at times, a bone marrow scan, is now the preferred scintigraphic approach for identifying the infected prosthesis. Newer imaging agents such as technetium leukocytes and radiolabeled antibodies are now being studied to determine their role in the management of prosthetic infection.