Prosthesis-Related Abscess on In-111 Leukocyte SPECT/CT Imaging

Excerpt

A 77-year-old male with a history of right knee joint replacement 4 years ago presented with swelling and pain following a fall. He soon developed fever with an elevated WBC count, ESR and CRP levels. Blood cultures were negative. Whole body images were acquired in anterior and posterior projections after the intravenous administration of 543 μCi of In-111-labeled autologous WBCs (a,b). They showed a large area of abnormal accumulation of labeled WBCs in the right thigh. CT and fused SPECT/CT images in the coronal plane (c,d) localized the uptake to the antero-lateral aspect of the right femoral prosthesis, extending into the knee. Transaxial CT and fused SPECT/CT images (e,f) localized the uptake to an abnormal density with an air-fluid level (e) characteristic of an abscess (Fig. 1). The patient underwent drainage, irrigation and debridement.

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