Evaluation of Fluorodeoxyglucose Positron Emission Tomography (F18-FDG PET) scans in infection of the extremities

Following study enrolment each patient will undergo a FDG PET-CT in addition to a labelled leukocyte study +/- bone scan. The labelled leukocyte study +/- bone scan are routine clinical care, and the FDG PET-CT scan of the peripheries is in addition to routine care. The routine care options for participants will differ on a case by case basis, and are listed in the Comparator/Control field below.The white cell scans and the FDG PET-CT scan will be performed within a week of each other. Patients will be followed for up to 3 months to record subsequent treatment regimens: antibiotics, surgery, radiological and clinical responses to therapy and biopsy results when performed. Patients will be required to fast for 4-6 hours An intravenous cannula will be inserted into a peripheral vein and the blood sugar level (BSL) recorded. If fasting BSL > 11.1mmol/l the reporting PET physician will decide if study is to proceed or be re-scheduled. Aporoximately 4 MBq/kg of 18F-FDG (maximum 250 MBq) will be administered intravenously. Patient will rest quietly for one hour. Mobilisation is discouraged during the ‘uptake phase’. PET-CT imaging will be performed on Siemens PET-CT, one hour following FDG administration, over 2-3 bed positions with CT field of view limited to area of interest in extremities. Image reconstruction will include CT attenuation correction.