Comparison of magnetic resonance imaging and 99mTechnetium-labelled methylene diphosphonate bone scintigraphy in the initial assessment of chronic non-bacterial osteomyelitis if childhood and adolescents

Objectives To compare sensitivity of bone scintigraphy using (99m)Technetium-labelled methylene diphosphonate (Tc-99m MDP) and magnetic resonance imaging (MRI) in the detection of inflammatory bone lesions in patients with chronic non-bacterial osteomyelitis (CNO). Methods Tc-99m MOP bone scintigraphy and MRI were performed in 32 CNO patients at the time of diagnosis and compared regarding their sensitivity in detecting inflammatory lesions in symptomatic regions of the body. Results Inflammatory lesions could be detected in 40 out of the 54 (74.1%) symptomatic regions by bone scintigraphy and in 53 (98.1%) of these regions by MRI (p<0.001). Sensitivity of MRI compared to bone scintigraphy was superior in detecting lesions in the long bones of the thigh and the lower legs (100% vs. 78.4%, respectively, p<0.05). Conclusion Bone scintigraphy does not seem to display the whole extent of the inflammatory process in CNO. Therefore, depending on clinical relevance, MRI rather than planar bone scintigraphy should be considered for the detection of CNO lesions at diagnosis.