[Sensitivity and specificity of the Tc-99m ciprofloxacin scan in pediatric osteomyelitis]. / Sensibilidad y especificidad del gammagrama ciprofloxacino-Tc99m en osteomielitis infantil.

INTRODUCTION: The Tc-99m-ciprofloxacin complex, introduced in 1993, has been extensively evaluated all over the world with good results for the diagnosis of active bacterial osteoarticular infections. There are only a few publications on the use of this procedure in pediatric ages. In our study we evaluated the efficacy of the Tc-99m ciprofloxacin scan for the diagnosis of osteoarticular infections in the pediatric population assessing its sensitivity, specificity, and positive and negative predictive value. MATERIAL AND METHODS: A retrospective, descriptive, observational study was done in 94 patients with clinical suspicion of osteoarticular infection in whom a Tc-99m ciprofloxacin bone scan was performed; the diagnosis was confirmed with intraoperative cultures and blood cultures. The results obtained with the Tc-99m ciprofloxacin scan and the culture reports were analyzed, as well as the sensitivity, specificity and the positive and negative predictive values of the Tc-99m ciprofloxacin scan. RESULTS: Among the patients with intraoperative and blood cultures, 80 cases (85.1%) were positive and 14 cases (14.9%) were negative for bone infection. In the Tc-99m ciprofloxacin scan 78 cases (83%) were found to be positive for infection and 16 cases (17%) were negative. There were two false negatives. We found a 97.6% sensitivity and 100% specificity, with a 100% positive predictive value and an 87.5% negative predictive value. CONCLUSION: The Tc-99m-ciprofloxacin complex is useful to make the differential diagnosis between inflammation and infection in pediatric patients in whom an osteoarticular infectious process is suspected.

[Minimally invasive surgery efficacy in children's forefoot]. / Eficacia de la cirugía mínimamente invasiva en el antepié de los ninos.

Minimally invasive surgery (MIS) in children's forefoot is a technique that permits minimum tissue trauma assisted by fluoroscopic control. We evaluated the results of this modality of surgery in problems such as: claw toes, hallux valgus, exostosis, hammer toe, and bunionectomy. We had a complication for using the procedure with more revolutions per minute (rpm), which remind us of the importance of using 2000-8000 rpm. We found that it is not commendable to make hypercorrections, due it increases they risk of recurrence. MIS is an excellent option in forefoot deformity correction in children leaving minimal scars and preserving the physis.