Primary Chronic Sclerosing Osteomyelitis: A New Diagnostic Tool

Aims: Primary chronic sclerosing osteomyelitis is a rare and complex pathology and remains a diagnostic and therapeutic challenge. Our aim is to show our experience with a new diagnostic tool. Material and Methods: Four patients aged from 26 to 67 were referred to the department of oral and maxillofacial surgery of University Hospital CHUV in Lausanne between January 2010 and December 2018 for chronic mandibular pain without infectious signs nor symptoms. All patients underwent three-phase bone scintigraphy and anti-granulocyte antibody scintigraphy. Results: Three-phase bone scintigraphy demonstrated radiotracer uptake at the zone of pain, whereas anti-granulocyte antibody scintigraphy showed no uptake, thus rendering an infectious origin unlikely. Conclusion: A combination of the two different scintigraphies should be considered in order to guide the clinician in the diagnosis of primary chronic sclerosing osteomyelitis, thus preventing patients from undergoing unnecessary imagery and useless treatment, and also allowing an early diagnosis.