F-18 FDG PET in the diagnosis and monitoring of salmonella vertebral osteomyelitis: a comparison with MRI.

Vertebral osteomyelitis may be difficult to diagnose by conventional imaging methods. F-18 FDG PET is capable of detecting a lesion in the very early stages, long before there are any visible structural changes. We present a case of salmonella vertebral osteomyelitis in which F-18 FDG PET scanning provides the diagnosis by detecting increased metabolic activity before definitive changes are seen on plain radiography and magnetic resonance imaging (MRI). The imaging findings and SUV on serial follow up F-18 FDG PET studies improved and normalized in correlation with the clinical and biochemical indices, whereas the MRI abnormalities persisted. This assisted in the decision to stop long-term antimicrobial therapy.