PET imaging in MSK infections

Musculoskeletal infections are highly feared, form a major burden on healthcare, and may lead to severe morbidity and mortality. The diagnosis may be difficult with non-specific symptoms requiring multiple diagnostic investigations. FDG-PET/CT is one of them showing good diagnostic accuracy in most musculoskeletal infections. However, one has to be aware of the non-specific FDG uptake in patients with metallic implants and in the postsurgical phase. In this chapter, the advantages and disadvantages of the use of FDG-PET/CT in musculoskeletal infections in described for several indications: infections in the peripheral bone, spine infections/spondylodiscitis, prosthetic joint infections, diabetic foot infections, and sternal bone/wound infections. Recent published guidelines and diagnostic flowcharts by delegates of the European Association of Nuclear Medicine in collaboration with delegates from other (clinical) societies, will be discussed. At the end of this chapter, recent developments in tracer and camera systems will be presented.