The role of nuclear medicine in the management of mycetoma

Objective: To define the role of nuclear medicine scanning in patients with mycetoma. Methods: Between the year 1988 and 2001, 15 patients had undergone three-phase bone and, when indicated, Gallium scanning. Results: Twelve patients (80%) had positive bone infections on the first scans, 8 with Actinomycetoma (AM) and 4 with eumycetoma (EM) and the other 3 had only soft tissue infection. Two patients had more than one bone lesion and the rest of the patients had a single lesion. The most frequent site of bone infection was in the foot (53%) followed by the hands or legs (13%). Nine patients (59%) (7AM and 2 EM) had eventually negative bone scans. Conclusion: In patients with mycetoma, three phase bone scan must be included in the work up plan as early as possible and, together with Gallium scanning, in the follow up work. Because f its high rate of sensitivity, three phase bone scan is an essential tool on the diagnosis of mycetomas, in the evaluation of their response to treatment and as criterion of cure of the disease. Gallium scanning must be reserved in the follow up cases