pyrophosphate and Athletic-Injuries

The radionuclide investigation of skeletal trauma in the past was confined generally to scintimetry and an occasional bone scan. The development of improved radiopharmaceuticals, including 99mTc-labeled compounds with their enhanced sensitivity, and the refinement of imaging devices offering superior resolution and speed have allowed a more detailed assessment of conditions resulting from trauma. Practical approaches to the diagnosis of subtle bone injury resulting in stress fracture, the differentiation between delayed healing and nonunion, and early recognition of avascular necrosis and osteomyelitis are now available. The changing pattern of radionuclide uptake in bone following damage by radiation and other abnormalities as a consequence of trauma also can be easily studied.

Topics: Adolescent; Adult; Athletic Injuries; Calcium Radioisotopes; Child; Diphosphates; Female; Femur Head Necrosis; Fluorine; Fractures, Bone; Fractures, Spontaneous; Fractures, Ununited; Humans; Male; Middle Aged; Myositis Ossificans; Osteomyelitis; Radiation Injuries; Radionuclide Imaging; Radiotherapy; Strontium Radioisotopes; Technetium

Total body Tc-99m pyrophosphate scintigraphy was performed on 11 "ultramarathon" runners to assess the ability of nuclear medicine techniques to evaluate skeletal-muscle injury due to exercise. We found increased muscle radionuclide concentration in 90% of the runners. The pattern of muscle uptake correlated with the regions of maximum pain. The detection of exercise-induced rhabdomyolysis appeared to be best when scintigraphy was performed within 48 hr after the race, and to be almost undetectable after about a week. It was possible to differentiate muscle injury from joint and osseous abnormalities such as bone infarct or stress fracture. Although 77% of the runners had elevated serum creatine kinase MB activity, cardiac scintigraphy showed no evidence of myocardial injury.

Topics: Adult; Athletic Injuries; Creatine Kinase; Diphosphates; Heart; Humans; Male; Middle Aged; Muscles; Pain; Physical Exertion; Radionuclide Imaging; Running; Technetium; Technetium Tc 99m Pyrophosphate