Prognostic value of focal scintigraphic findings in clinically suspected cases of tibial stress fracture

Abstract

ObjectiveTo investigate the correlation between tracer uptake on bone scintigraphy and recovery time in patients with tibial stress fracture.Materials and MethodsWe evaluated two groups of athletes: those with clinical suspicion and a radiological diagnosis of tibial stress fracture (TSF group, n = 21); and those with no symptoms or evidence of fracture (control group, n = 10). All subjects underwent bone scintigraphy and magnetic resonance imaging with a maximum interval of 7 days between the assessments.ResultsUsing the region of interest technique, we obtained a quantitative evaluation index, comparing affected and unaffected legs. The mean uptake of 99mTc-MDP was significantly higher in the TSF group than in the control group (2.54 ± 0.77 vs. 1.05 ± 0.11; p < 0.001).ConclusionIn our sample of athletes, determining the bone scintigraphy uptake indices provided an objective method to estimate the appropriate recovery time after a tibial stress fracture.

Evaluation and Diagnosis of Tibial Bone Stress Injuries in Adolescents: Imaging and Nomenclature

“…25 Castropil and colleagues compared bone scan with MRI and developed a quantitative evaluation index (QEI) that compared injured and non-injured legs, identifying a positive correlation between QEI to time for recovery. 73 Because many early studies looking at BSI used bone scan as the gold standard, accurate representation of sensitivity and specificity of the test is lacking. A systematic review looking at the use of bone scan in lower extremity stress fractures in patients of all ages reported a sensitivity of 50-97%, with specificity ranging from 33-98%.…”

Focal scintigraphic findings in clinically suspected tibial stress fractures

“…Using the score devised by Chisin et al ( 9 ) as the basis for quantification of the findings, the authors demonstrated an objective correlation to estimate the appropriate recovery time after a tibial stress fracture. Castropil et al ( 8 ) found a statistically significant linear relationship between the quantification of uptake and the time required for adequate recovery. These encouraging results, because of the potential impact on the more assertive behavior of patients recovering from stress fractures, open space for new clinical studies.…”

“…In view of the difficulties discussed above, we congratulate Castropil et al on their study, published in the previous issue of the Radiologia Brasileira , which evaluated the potential of scintigraphy to facilitate the clinical management of patients diagnosed with stress fractures ( 8 ) . Using the score devised by Chisin et al ( 9 ) as the basis for quantification of the findings, the authors demonstrated an objective correlation to estimate the appropriate recovery time after a tibial stress fracture.…”