Techetium 99m methylene diphosphonate bone scanning in osteoarthritic hands

Abstract

In this prospective study, the radiological features characteristic of osteoarthritis of the hand were compared with the radionuclide bone scan images. A total of 32 patients was assessed at 6-monthly intervals for 18 months. Microfocal radiographs were taken at each visit. The high magnification and resolution of this technique permitted direct measurement of joint space width, subchondral sclerosis, osteophyte number and area and juxta-articular radiolucency area for each joint in the hand. Four-hour technetium 99m methylene diphosphonate bone scans were taken at 0 and 12 months and the activity of tracer uptake at each joint scored. The latter was compared with each X-radiographic feature at every visit and the changes between visits analysed. The scan scores did not correlate with any of the X-radiographic features other than osteophyte size. During the study the size of growing and remodelling osteophytes increased significantly at joints with raised or increased isotope uptake.

Skeletal SPECT/CT of the peripheral extremities -interdisciplinary approach in orthopaedic disorders-first clinical results

“…Bone scintigraphy of the peripheral extremities is an excellent tool to detect orthopedic disorders [1][2][3][4][5][6][7][8][9][10][11][12][13][14][29][30][31]. However, the evidence on the value of hybrid imaging of the peripheral extremities is scarce.…”

“…Several reports emphasize the high sensitivity of bone scintigraphy [1][2][3][4][5][6][7][8][9][10][11]. However, it is also well known that the specificity of bone scintigraphy is quite low due to the lack of anatomic information, especially in the peripheral extremities, although pinhole SPECT may improve the diagnostic accuracy of imaging the peripheral extremities [12].…”

Investigation of joint disease

“…The normal response of bone to increased stress is directed to reducing the forces at each point, by strengthening the bone and increasing the stress-bearing area, identified radiologically as sclerosis and osteophytes. An increased uptake of bone-seeking tracers precedes the radiographic changes (Buckland-Wright et al 1990), whilst extensive osteophytes may be present in subjects who have no scintigraphic manifestation, if reactive new bone formation has ceased or the subjects are, and have been, asymptomatic. During movement, very high pressures develop within joints, and these may be sufficient to drive synovial fluid through defects in the cartilage cap into underlying bone, with a consequent formation of the characteristic cysts.…”

SPECT/CT in patients with lower back pain after lumbar fusion surgery

“…Bone scintigraphy is frequently used for the diagnostic evaluation of orthopedic disorders because altered bone metabolism can be detected before morphologic changes are detected with planar radiography [8][9][10][11][12][13][14][15][16][17][18]. It is particularly valuable in evaluating prostheses of the hip joints and knees as their loosening leads to periprosthetic augmentation of bone metabolism, which is easily picked up by this technology [19].…”