Nuclear medicine techniques: a better weapon in detecting a rare case of epiphyseal osteomyelitis caused by Salmonella in a patient without sickle cell disease

Introduction An osteomyelitis may be difficult to diagnose by conventional imaging methods; nuclear medicine imaging can detect a lesion in the very early stages, highlighting the metabolic changes preceding structural ones. We present a case of Salmonella os- teomyelitis in a 26-year-old woman, involving the distal epiphysis of the right femur. Case report The involvement usually affects a single joint, but also vertebrae or any other bones can be involved; frequently, an osteomyelitis caused by Salmonella is associated with par- ticular pathological conditions like immunodepression due to corticos- teroid treatment, systemic lupus ery- thematosus, renal transplantation, sickle cell disease or pre-existing joint disease 4 . The pathology in im- munocompetent adults is usually due to the ingestion of contaminated food products 2 . The onset of such pathology in young patients, in the absence of sig- nificant anamnestic data, can hardly be recognised, although a prompt and correct diagnosis is absolutely necessary. Conventional imaging suffers from lack of specificity, especially at the ear- ly stage of the disease. Conversely, nu- clear medicine imaging can be useful for diagnosing and monitoring Salmo- nella bone lesions, giving more infor- mation than conventional imaging 5,6 .