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The Use of Tc-99m-Recombinant Human Annexin V Imaging for Differential Diagnosis of Aseptic Loosening and Low-Grade Infection in Hip and Knee Prostheses JOURNAL OF NUCLEAR MEDICINE Lorberboym, M., Feldbrin, Z., Hendel, D., Blankenberg, F. G., Schachter, P. 2009; 50 (4): 534–37

Abstract

The aim of this study was to assess the pattern of annexin V uptake in hip and knee prostheses suspected of being infected.A total of 7 patients undergoing revision surgery for hip or knee prostheses were studied; 5 patients had total hip replacements, and 2 had total knee replacements. Infection was confirmed by pathology, culture results, laboratory evaluation, and clinical follow-up. All patients also underwent a bone scan before surgery.Annexin V scan findings were positive in 5 patients and negative in 2. Annexin V uptake was either focal (n = 4) or linear (n = 1). There were 4 true-positive, 2 true-negative, 1 false-positive, and no false-negative annexin V studies. Annexin V uptake was either more extensive or less extensive than, and usually was incongruent with, (99m)Tc-methylene diphosphonate uptake.Our findings suggest that annexin V imaging shows greater uptake with infection than with aseptic loosening and has a high negative predictive value for prosthetic infection.

View details for DOI 10.2967/jnumed.108.059345

View details for Web of Science ID 000272487200008

View details for PubMedID 19289427