Detection of Sacro-Iliitis: A Comparison between Profile Scanning with the Use of^99mTc Pertechnetate and Scintigraphy with^99mTc Diphosphonate

Abstract

Comparative evaluation of the sensitivity of 99mTc pertechnetate scanning and of 99mTc diphosphonate scintigraphy in detecting sacro-iliac arthritis (S.I.) was performed in 32 patients with definite S.I., 14 with probable S.I., and 6 with inactive S.I., 14 patients without any evidence of S.I. served as controls. Greater diagnostic accuracy was obtained by 99mTc pertechnetate scanning than with 99mTc diphosphonate scintigraphy in patients with active S.I. in the early stages before radiological changes had become evident and in patients 22 years old and younger. In patients with inactive S.I. a close correlation was found between clinical, radiological, and scintigraphical results with 99mTc diphosphonate scintigraphy. An index obtained by adding the uptake values measured by both methods in each subject yielded valuable information in patients with S.I. that is clinically difficult to differentiate.

Limited Diagnostic Value of Unilateral Sacroiliitis in Scintigraphy in Assessing Axial Spondyloarthritis

“…Our findings are in concordance with the few scintigraphy studies that have so far reported on unilateral sacroiliitis (6, including 104 patients with axial SpA and 36 controls) [7][8][9][10][11][12] . Sensitivities of unilateral sacroiliitis in these studies were low, ranging from 6.3% 10 to 33.3% 12 , while specificities were high, ranging between 89.5% 8 and 94.1% 7 , resulting in a pooled LR of 2.1.…”

The diagnostic value of scintigraphy in assessing sacroiliitis in ankylosing spondylitis: a systematic literature research

“…AS, ankylosing spondylitis; MLBP, mechanical low back pain; NA, not available.*AS: information about disease duration given in six studies,23 28 34 37 46 48 about gender distribution in nine studies,28 34–38 40 46 48 about age given in 10 studies,23 28 34 – 38 40 46 48 and about HLA-B27 in seven studies 23 24 28 35 37 38 47

†Suspected sacroiliitis: information about disease duration given in two studies (mean disease duration 2.3 years53 and 3.8 years46), about gender distribution in five studies,29 42 44 51 53 about age in five studies,29 31 46 51 53 and about HLA-B27 in five studies 24 29 42 50 52

…”

“…*AS: information about disease duration given in six studies,23 28 34 37 46 48 about gender distribution in nine studies,28 34–38 40 46 48 about age given in 10 studies,23 28 34 – 38 40 46 48 and about HLA-B27 in seven studies 23 24 28 35 37 38 47…”

“…†Suspected sacroiliitis: information about disease duration given in two studies (mean disease duration 2.3 years53 and 3.8 years46), about gender distribution in five studies,29 42 44 51 53 about age in five studies,29 31 46 51 53 and about HLA-B27 in five studies 24 29 42 50 52…”

“…Sensitivity could be further calculated for those patients with AS with x -ray grade 2 or 3 findings (excluding grade 4) for 244 patients with AS from 11 studies23 28 35 – 37 39 – 41 46 – 48), 160 of these had positive findings by scintigraphy resulting in a sensitivity of 65.57%.…”