Journal of Isfahan Medical School

Journal of Isfahan Medical School

Evaluation of Diagnostic Accuracy of 99mTc-UBI Scans in Discrimination of Infectious vs Non-Infectious Inflammation of Hip and Joint Arthroplasty

Document Type : Original Article(s)

Authors
Sina Rezazadeh Sarabi 1
Seyyed Mohammad Abedi Valoukolaei 2
Sohil Ebrahimpour 3
Hemmat Gholinia 4
Majid Khalilizad 5
1 Orthopedic Surgeon, Mazandaran University of Medical Sciences, Ramsar School of Medicine, Ramsar, Iran
2 Department of Radiology and Nuclear Medicine, Faculty of Medicine, Mazandara University of Medical Sciences, Sari, Iran
3 Associate Professor of Clinical Sciences (By Research), Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
4 Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
5 Assistant Professor of Surgery of the Knee, Department of Orthopedics, School of Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
10.48305/jims.v44.i863.0788
Abstract
Introduction: With the growing number of orthopedic procedures, implantation of surgical prostheses has significantly increased. Although less than 10% of patients develop infection-related complications, distinguishing bacterial infection from non-infectious inflammation remains clinically important. The radiopharmaceutical 99mTc-UBI has shown potential to differentiate these conditions. This study evaluated the diagnostic accuracy of 99mTc-UBI imaging in discriminating bacterial infection from non-infectious inflammation in hip and knee arthroplasty implants.
Methods: In this cross-sectional diagnostic study, patients who underwent hip or knee replacement at Rouhani or Shahid Beheshti hospitals in Babol (2021–2024) were regularly followed up at orthopedic clinics. Those with suspected prosthetic joint infection underwent nuclear scanning. The gold standard was two positive cultures from the same microorganism or visible pus during surgery. Scan results were considered positive if delayed-phase uptake in the suspicious joint was equal to or greater than hepatic uptake.
Results: Among 67 patients, 39 (58.2%) had hip and 28 (41.8%) had knee replacements. Based on culture results, 9 patients (13.4%) had prosthetic infection, while scans identified 8 cases (11.9%). The correlation between scan and culture findings was statistically significant (P<0.001). The 99mTc-UBI scan demonstrated 89% sensitivity, 100% specificity, and 98.5% accuracy for overall infection detection. For hip implants, sensitivity was 83%, specificity 100%, and accuracy 96.4%; for knee implants, diagnostic value reached 100%.
Conclusion: 99mTc-UBI imaging provides high diagnostic accuracy in differentiating bacterial infection from non-infectious inflammation in both knee and hip implants. As a non-invasive method, it effectively facilitates clinical follow-up and treatment decision-making.

Highlights

Sina Rezazade: Google Schola

Seyed Mohammad Abedi: Google Scholar

Soheil Ebrahim Pour: Google Scholar

Majid Khalilizad: Google Scholar

Keywords
Precision diagnostic
Radiopharmaceutical 99mTc-UBI
Infection
Knee Implant
Hip Implant
Scan
Subjects
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Journal of Isfahan Medical School
Volume 44, Issue 863
3rd Week, July
July and August 2026
Pages 788-794

  • Receive Date 30 June 2026
  • Accept Date 12 July 2026