How do you know if a sinus infection is osteomyelitis?

I have had osteomyelitis in the sinus on more than one occasion   The pain was so intense and the typical antibiotics were not making me well.  My ENT consulted a colleague who suggested that I have a Gallium Scan.  The colleague thought that I might have osteomyelitis (an infection in the bone).  This was my ENT’s first encounter with someone who possibly could have osteomyelitis.  I was directed to the x-ray department of our local hospital to have the test done.

A Gallium Scan is a test using radioactive material called gallium to look for swelling, infection or cancer in the body.  The scan is a type of nuclear medical exam.  

I arrived at the lab and was injected with  radioactive gallium into a vein in my arm.  I was told that the gallium would travel through my blood stream and if I had a bone infection it would collect in the bone.  I was instructed to go home and come back a few hours later to allow the gallium time to travel through the blood stream.  When I returned to the lab I was placed on a table and was instructed to lie still while a special camera able to detect gallium would see whether it had gathered in my sinuses.  The test took me about thirty minutes.  The result was that I did, indeed, have a bone infection in my sinuses.  The treatment was six weeks of IV antibiotics.

After six weeks of IV therapy I was once again sent to the lab.  The best way to determine if the infection was gone was to have a White Blood Cell Scan.  Again,  radioactive material was used. My blood was drawn and the white blood cells were isolated and tagged radioactively and re-injected into my arm.  A scan was done a day later to see if the radioactively tagged white blood cells settled in the sinuses.  While the test showed I was over the infection, I was uncertain because I still did not feel great and that little voice in my head said the battle wasn’t over.  I was so right!

The question of how you know if a sinus infection is osteomyelitis was a search question.  I think the Gallium Scan is probably the most definitive test from what I have read and is the test my doctor used.  CT Scans and MRI’s can be ordered but may not show the entire picture.  I would love to show you a picture of a Gallium Scan but don’t want to risk copyright infringement.  Just imagine a typical x-ray with a bright yellow glow.  The bright yellow glow is the radioactive gallium that pooled in my sinuses.

This is my experience with detecting whether or not my sinus infection was a typical infection or osteomyelitis of the sinus.  Only a medical practioner can make the determination of whether or not someone has osteomyelitis based on symptoms and tests that he or she chooses to prescribe.

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