Isotope Studies in Normal and Diseased Knee Joints: 99mTc Uptake Related to Clinical Assessment and to Synovial Perfusion Measured by the 133Xe Clearance Technique

Abstract

1. Uptake of intravenously administered radioactive technetium (99mTc) was measured over the knee joints in normal human volunteers, in patients with osteoarthritis and in groups of synovectomized and unoperated patients with rheumatoid arthritis. The uptake was compared with clinical indices of inflammation (pain, tenderness swelling and stiffness), and the clearance rate of intra-articularly injected radioactive xenon (133Xe). The 99mTc uptakes were found to be unrelated to the isotope dose and the day-to-day reproducibility was acceptable.2. The mean uptake of 9 9 m T~ was within normal limits in osteoarthritis. Both in synovectomized and in unoperated rheumatoid arthritis 99mTc uptake was significantly higher than in normal subjects.3. Of the clinical indices studied significant correlation of 9 9 m T~ uptake was found with pain and swelling in all groups of patients studied.4. Faster clearance of 33Xe in unoperated rheumatoid arthritis correlated well with the higher 9 9 m T~ uptakes. 5.The results confirm that 99mTc uptakes are raised in inflammatory arthritis but not in degenerative arthritis. The relation of 99mTc uptake to the clinical indices of inflammation and to the 133Xe clearance from the joint is discussed.Although radioactive technetium (99mTc) has been extensively employed in scanning studies of many organs (McCready,

Resorption of intraarticular diffusible and microcolloid tracers: Rabbit studies of normal and synovitic knees

“…Removal of the diffusible tracer from the knee was increased in acute synovitis with hyperemia, and this has been previously demonstrated by using radioactive inert gases or radioactive microspheres (Dick et al 1971, Christensen et al 1982, Piepsz et al 1982. Chronic synovitis showed the same disappearance curve for the diffusible tracer as the normal knee and subcutaneous tissue.…”

“…The results indicate (1) that in synovial tissue lymphatic transport is of little importance, (2) that leakage through the synovial membrane increases in synovitis, and (3) that a subcutaneous depot can be used as a reference instead of injections into a normal knee. The resorption by either blood or lymph of synovial fluid through the synovial membrane of normal and inflammatory joints has been studied by several authors using inert or radioactive tracers (Dick et al 1971, Wdowiak et al 1980, Christensen et al 1982. We found earlier that 99mtechnetium-labeled albumin colloid is suitable for following particle absorption from knee joints .…”

Studies on 2-(3-benzoylphenyl) propionic acid (Orudis). A double-blind cross-over trial in patients with rheumatoid arthritis and an assessment of its influence on hepatic drug-metabolizing enzymes.

“…The method has been previously described (Chalmers, Cathcart, Kumar, Dick, and Buchanan, 1972) and is a modification of that developed by Dick, Neufeld, Prentice, Woodburn, Whaley, Nuki, and Buchanan (1970) and Dick, Deodhar, Provan, Nuki, and Buchanan (1971).…”

Clinico-pharmacological studies and clinical evaluation of flurbiprofen. A new non-steroidal antirheumatic agent.

“…A slight modification of the procedure described by Dick and his colleagues was used (Dick, Neufeld, Prentice, Woodbum, Whaley, Nuki, and Buchanan, 1970;Dick, Deodhar, Provan, Nuki, and Buchanan, 1971). Approximately 200 ,uCi of 99mTc (as sodium pertechnetate) was standardized by counting for 2 min at 30 cm., using a thalliumactivated sodium iodide scintillation crystal and photomultiplier.…”