Three phasic radionuclide imaging with Technetium 99m is a modality for early diagnosis of acute osteomyelitis.

• Radionuclide imaging can be valuable in suspected bone infection, especially early in the course of infection, and when multiple foci are suspected, or an unusual site such as the pelvis, is suspected.
• Technetium-99 methylene diphosphonate (TC 99m), accumulates in areas of increased bone turnover and is the preferred agent for radionuclide bone imaging (3 phase scan).
• Inflammation and increased vascularity in osteomyelitis result in increased concentration of 99m Tc, especially in the 3rd phase (4-6hr later).^[1]

The following video and images show bone scans of patients with osteomyelitis.

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