False-negative triple-phase bone scans in spinal cord injury to detect clinically suspect heterotopic ossification: a case series

J Spinal Cord Med. 2008;31(2):194-6. doi: 10.1080/10790268.2008.11760711.

Abstract

Background/objective: Heterotopic ossification (HO) is a complication seen in patients after spinal cord injury (SCI). Triple-phase nuclear bone scanning is the most sensitive test for the detection of HO. This retrospective study assesses whether patients with clinically suspected HO but negative triple-phase nuclear bone scans develop delayed positive nuclear bone scans.

Case series: A cohort of patients with SCI and clinically suspected HO who underwent triple phase nuclear bone scans over a period of 2 years was identified from retrospective chart review of an acute inpatient SCI rehabilitation service. A subgroup of 7 patients with initially negative but subsequently positive triple-phase nuclear bone scans was identified, and the following data were collected: date, mechanism, admission level, and admission completeness of injury as well as date, number, and results of bone scans. Laboratory studies were also collected during the time of imaging.

Results: Over a 2-year period, 343 patients were admitted to the SCI rehabilitation service; 60 patients were suspected of having HO and underwent a total of 85 triple-phase nuclear bone scans. Seven patients were identified with initially negative but subsequently positive bone scans.

Conclusions: In patients with clinically suspicious HO but negative bone scans, follow-up scans are indicated to identify initial false-negative studies.

MeSH terms

  • Bone and Bones / diagnostic imaging*
  • Bone and Bones / pathology*
  • Bone and Bones / physiopathology
  • Cohort Studies
  • Diagnostic Errors / prevention & control
  • False Negative Reactions
  • Femur / diagnostic imaging
  • Femur / pathology
  • Femur / physiopathology
  • Humans
  • Ossification, Heterotopic / diagnostic imaging*
  • Ossification, Heterotopic / etiology
  • Ossification, Heterotopic / pathology*
  • Pelvic Bones / diagnostic imaging
  • Pelvic Bones / pathology
  • Pelvic Bones / physiopathology
  • Positron-Emission Tomography / statistics & numerical data
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Spinal Cord Injuries / complications*