Ga-67 Scintigram in the Diagnosis of Infection of Masticator Muscles Due to an Odontogenic Infection

A 36-year-old man had a mandibular swelling and severe difficulty opening his mouth. His left lower wisdom tooth had been extracted 2 days before. He had a high fever (39°C), leukocytosis (9,300/ml), and an elevated C-reactive protein level (9.66 mg/ml). Ga-67 scintigraphy showed intense uptake in the mandible and masticator muscles. SPECT images displayed in maximum intensity projection format clearly defined the inflamed internal and external pterygoid muscles and masseter and temporalis muscles. Although each masticator muscle was severely swollen by the infection, the fascial structure was well preserved. Repeated antibiotic therapy ultimately controlled the infection.