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Indium 111 – Labeled Leukocytes

- Discussion:
    - if suspected osteomyelitis is superimposed on a disease that causes increased bone remodeling, the combined Indium-111-labeled
          leukocyte-Technetium-99m bone scan is the procedure of choice in non-marrow-containing skeleton and the Indium-111-labeled leukocyte
          and Technetium-99m bone marrow scans are the procedures of choice in marrow-containing skeleton.
    - indium WBC preparations require withdrawing approx 50 ml of autologous blood with a leukocyte count of approximately 5,000 per ml;
         - leukocytes are collected by centerfuge, exposed to Indium, and re-injected IV;
    - images obtained at 24 hours show activity only in the liver, spleen, & bone marrow; - most studies are taken at 24 hrs;
    - normal healing wounds and fully treated infections with no significant degree of inflammation show no disernable uptake;
         - providing IV antibiotics does not affect the test;
    - false positive: IM injection sites, non-infected fracture, total joint prosthesis, and rheumatoid arthritis;
         - overlying soft tissue infection may also cause false positive