Normal Tc-99m bone scans have been reported where there were radiographically and surgically proven sites of active disease. This finding may be due to either the indolent nature of the infection or overwhelming infection inciting little bone response. Ga-67 citrate scintigraphy is useful to define total extent of infection and follow response to therapy since the scans resolve within months of initial therapy. No explanation could be found for this. In the instances of negative scans, In-111 white cell imaging may be useful, but this experience is limited.
Tuberculous spondylitis is a complex disease with varied manifestations.
Radionuclide imaging is valuable in detection and follow-up of this disease. When radionuclide imaging is normal, one should obtain tissue specimen to confirm or exclude presence of disease. False normal imaging in spinal tuberculosis. Lifeso RM, et al. Tuberculous spondylitis in adults.