What is the role of technetium Tc 99 methylene diphosphonate bone scanning in the workup of malignant otitis externa (MEO)?

Updated: Apr 13, 2020
  • Author: Brian Nussenbaum, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Technetium Tc 99 methylene diphosphonate bone scanning is based on binding to osteoblasts. This scan depicts as little as a 10% increase in osteoblastic activity. However, this test is not specific since tumors or bony dysplasias, in addition to osteomyelitis, can cause osteoblastosis.

It is useful in the initial evaluation because a positive finding in the correct clinical context can lead to confirmation of the diagnosis.

The test is not useful for assessing the response to therapy since results remain persistently positive long after clinical improvement because of continuous bone remodeling and reformation.

This test may also have limited usefulness for patients with a prior history of mastoiditis or otologic surgery.

The application of single-photon emission computed tomography (SPECT) technology has improved the poor spatial resolution traditionally associated with this test.

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