The periarticular uptake of 99mtechnetium-labeled diphosphonate (99mTcDp) was compared in 12 patients hospitalized for psoriasis and in 12 hospitalized for other dermatoses not associated with arthropathy. The 12 patients with psoriasis had recent onset disease of less than 5 years duration; neither group had historical or clinical evidence of arthritis. All psoriatics had markedly abnormal scans with symmetrically increased periarticular uptake about the imaged joints. None of the controls had similar findings. In 4 patients scanned with 99mtechnetium-pertechnetate within 24 hours of their 99mTcDP scan, no evidence of inflammatory synovitis was found. Three of these patients were serially imaged with 99mTcDP at intervals of 2 weeks to 3 months after their initial study, when obvious clinical improvement in their psoriasis was apparent. Improvement in the radionuclide joint images was demonstrated in some of the patients, but none reverted to normal during the study period. In light of recent evidence for the preferential binding of 99mTcDP to immature collagen, it is suggested that psoriasis may represent a generalized, but uncharacterized, collagen disorder present in bone as well as skin, linking the cutaneous disease with the potential for arthropathy.

Adult↗

PubMedDate not supplied

Quantitative scintigraphy using radiophosphate and radiogallium in patients with rheumatoid arthritis.

Quantitative scintigraphy of the wrist, MCP, and knee joints in patients with RA was performed using Tc-99m-MDP and Ga-67 citrate. Radiopharmaceutical uptake in affected joints was compared with uptake at 2 control reference sites (juxta-articular bone and soft tissue). Following a 6-week course of therapy with Sulindac, the patients' overall assessment of disease was improved, but the results of joint/bone and joint/soft tissue ratios were variable. Improvement using Tc-99m-MDP during the first 2 weeks of NSAID therapy was noted in the minimally inflamed wrist by joint/soft tissue measurement and in the maximally affected MCP joint by joint/bone ratio. There was no change in the joint ratios employing the Ga-67 citrate radiopharmaceutical. The initial qualitative score assigned to a joint using Tc-99m-MDP was in agreement with the calculated quantitative ratio except for the knee joint. Our results suggest that quantitative scintigraphy in its present format cannot be used as a reliable indicator to monitor the course of rheumatoid arthritis during NSAID therapy and subjective measurements are still the best judge of effective treatment.

Adult↗

PubMedDate not supplied

A prospective study comparing the clinical examination of peripheral joints with radionuclide scintigraphy in patients with rheumatoid arthritis.

Fifteen patients with classical rheumatoid arthritis were evaluated prospectively on 3 occasions to determine if any additional data could be obtained by joint scintigraphy which was not found by physical examination. Clinical and scan examinations were performed simultaneously and the scans were interpreted qualitatively by a radiologist without knowledge of the clinical findings. Simultaneous evaluations of 86 shoulder, elbow, knee, ankle, 84 wrist, 420 MCP and PIP, and 430 MTP joints were recorded. Concordance was noted in 67% of the evaluations and this was significant for the MCP, PIP, elbow, shoulder, knee, MTP, ankle, but not wrist joints. In 10% of instances the clinical examination was positive when the joint scan was negative. On average, the scan was positive 23% of the time (range 5-44%), when the clinical findings were normal. However, most of these scan abnormalities were due to minimal radionuclide uptake. The scan was most useful in the detection of MTP and ankle abnormalities which had been scored clinically negative, suggesting that greater attention be devoted to the clinical examination of the RA foot by the rheumatologist.

Adult↗

PubMedDate not supplied

Generalized skeletal response to 99mtechnetium methylene diphosphonate in rheumatoid arthritis.

The total body retention (TBR) and the 5- and 24-h lumbar spine to soft tissue (LS/ST) ratios of 99mtechnetium methylene diphosphonate was studied in 19 patients with rheumatoid arthritis (RA), 16 patients with metastatic tumors that did not involve the lumbar spine, 10 patients with chronic renal failure and 17 controls. The TBR was significantly higher in all groups compared to the controls. The 5-h LS/ST did not differ between any of the groups although the 24-h LS/ST ratios were significantly elevated in RA and those with chronic renal failure. The 24-h LS/ST in RA was correlated only with disease duration. The results are consistent with a generalized increase in bone turnover in RA and may explain the recognized lack of sensitivity of quantitative scintigraphic techniques in this disorder.

Adult↗

PubMedDate not supplied

An update on radionuclide imaging in hepatobiliary disease.

Explore the source record for details and available documents.

Biliary Tract Diseases↗

PubMedDate not supplied

Joint imaging in regional migratory osteoporosis.

We describe 4 patients (3 males aged 54-59, 1 female aged 25) with regional migratory osteoporosis (RMO). All patients had at least 2 episodes of periarticular osteoporosis. The interval between attacks ranged from 5 months to 11 yr and attacks lasted from 3 months to 2 yr. In 2 cases septic arthritis was initially suspected. The ankle joints were affected in 3 patients, hips in 2 and knees in 2. An unusual feature in 2 patients was involvement of the small joints of the foot demonstrated by 99mTc-methylene diphosphonate (99mTc-MDP) joint imaging. Joint imaging corroborated the clinical diagnosis in 2 patients before regional osteoporosis was visible radiologically. As there are no specific laboratory features of RMO, joint imaging may be helpful in the diagnosis of suspected cases before the development of radiographic stigmata.

Adult↗