pyrophosphate and Arthritis--Reactive

The polyetiology, the discrepancies in the initial manifestations, polymorphism in the course and the possibility of the ephemerality or absence of ocular, uro-genital and skin-mucosal manifestations create jointly the preconditions for a frequent diagnostic error in Reiter syndrome. The study confirmed the thesis that the diagnostic characteristics including the articular symptomatics are among the most striking ones. Synovial-arthritis and the involvement of the soft tissues are accompanied by disorders in the immune system with increased number of early T-lymphocytes, of Fc Gd and complement (C3b)-receptor lymphocytes and of spontaneously blast-transformed cells. The rheumatological process is characterized by proportionately accumulation of 99m Tc-pertechnetate and 99m Tc-pyrophosphate in the affected articular structures, with asymmetry of affection, with predilection and maximal capture of the radiopharmaceutical in the feet. The radioisotope information is on scanty alterations in the spine and sacroiliac joints. The complex study facilitates the timely diagnosis of the disease.

Topics: Adolescent; Adult; Arthritis; Arthritis, Reactive; Arthrography; Diphosphates; Female; Humans; Immunologic Tests; Male; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Pyrophosphate

Scintigraphic and radiometric investigation with 99mTc-pyrophosphate was carried out on the sacro-iliac joints of 79 patients: 48 with positive form of Behterev disease, 26 -- with probable form of the disease, 2 -- with Reiter syndrome and 2 -- with rheumatoid arthritis. Scintigraphy was combined with radiometric investigation (determination of sacro-iliac -- sacral index) with a view to obtaining quantitative information about the degree of accumulation of pyrophosphate in sacro-iliac joints. The data from the scintigraphic and radiometric investigations were juxaposed to clinical laboratory and X-ray investigations. Forty of the patients examined were HLA-B27 positive and 38 of them-HLA-B27 negative. Sacro-iliac index, determined in 13 healthy subjects (26 sacro-iliac joints) was within the limits of 1.18 +/- 0.094. The average value of the index of the 78 patients examined was 1.41 +/- 0.20. The index, during the first and second X-ray stage was 1.43 +/- 0.13 and 1.45 +/- 0.19 resp. The values decreased to 1.39 +/- 0.18 during the third X-ray stage, whereas in the fourth stage with completely ankylosis of the joints, the index was 1.20 +/- 0.07, being close to that of the control group of healthy subjects.

Topics: Adolescent; Adult; Arthritis, Reactive; Arthritis, Rheumatoid; Diphosphates; Female; HLA Antigens; Humans; Male; Middle Aged; Radionuclide Imaging; Sacroiliac Joint; Spondylitis, Ankylosing; Technetium

Bone scintigraphs obtained with both Technetium-99m polyphosphate and Technetium-99m pyrophosphate have been abnormal at the sacroiliac joints of 44 patients with definite ankylosing spondylitis (AS). Because of the normal registration of the sacroiliac joints on bone scintigraphy, it has been necessary to develop a profile-scan technique to quantify the abnormality that proves to be significantly different from the normal finding. In 17 patients with a strong clinical suspicion of AS but normal radiographs, the sacroiliac joints have frequently been abnormal. This finding is meaningful because there is a common occurence in this group of the histocompatibility antigen HL A-B27, known to be a marker of AS. We also note the frequency of abnormal sacroiliac scinitigrams in 26 patients with rheumatoid arthritis and in a group of other diseases-Crohn's disease, uveitis, psoriasis, ulcerative colitis, and Reiter's disease-all of which share some of the manifestations of AS.

Topics: Adult; Animals; Arthritis, Reactive; Arthritis, Rheumatoid; Cats; Colitis, Ulcerative; Crohn Disease; Diphosphates; Evaluation Studies as Topic; Humans; Psoriasis; Radionuclide Imaging; Sacroiliac Joint; Spondylitis, Ankylosing; Technetium; Uveitis

Scintigraphic exploration of the sacroiliac (S.I.) joints by 99 m-technetium pyrophosphate is simple and free of all danger. The fixation of the isotope in the right sacroiliac (R.S.I.) and the "normal" limits of the fixation ratios R.S.I./L.R. and the lumbar rachis (L.R.), visible on the same film. A series of 28 controls having made it possible to calculate the "normal" limits of the fixation ratios R.S.I./L.R. and L.S.I./L.R., the isotopic fixation was measured in 25 patients with sacroiliac inflammation, 21 of whom were rheumatic, 3 infectious. It was shown that scintigraphy could yield useful information on the evolution of sacroiliac inflammation, making an early diagnosis possible, and also contributing to differentiation between rheumatic and infectious inflammation.

Topics: Adult; Aged; Arthritis, Reactive; Back Pain; Bacterial Infections; Bone and Bones; Diphosphates; Female; Humans; Ilium; Joint Diseases; Male; Middle Aged; Osteoarthritis; Psoriasis; Radionuclide Imaging; Rheumatic Diseases; Sacroiliac Joint; Sacrum; Spinal Diseases; Spondylitis, Ankylosing; Staphylococcal Infections; Technetium; Tuberculosis, Spinal