pyrophosphate and Reflex-Sympathetic-Dystrophy

The authors report 5 observations of young adults, 3 teen-agers and 2 children suffering from algodystrophy, and in whom isotopic exploration of the skeleton disclosed a clear bony hypofixation during the entire evolution. These observations confirm their 1981 work concerning a young adult suffering from algodystrophy with isotopic bony hypofixation. Recent Canadian and American studies emphasize also the frequency of isotopic hypofixation in children algodystrophy. It seems, therefore, that isotopic bony hypofixation (linked perhaps to a decreased blood flow), is rather specific of algodystrophy in young subjects.

Topics: Adolescent; Adult; Bone and Bones; Child; Diphosphates; Diphosphonates; Female; Humans; Male; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Technetium; Technetium Compounds; Technetium Tc 99m Pyrophosphate

Topics: Adult; Child; Diphosphates; Femur Head Necrosis; Gallium Radioisotopes; Hip Joint; Humans; Infections; Joint Diseases; Legg-Calve-Perthes Disease; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Technetium; Technetium Tc 99m Pyrophosphate

The authors studied 20 patients suffering from algodystrophy (23 localizations) by triple scintigraphy with technetium, using pyrophosphate to study the importance of bone changes, marked red blood cells to measure the vascular volume, and pertechnetate to measure the interstitial compartment. These tests were done on the average 1.4 months after the outset of the disease. This work made it possible to demonstrate in the algodystrophy: a pronounced bone hyperfixation that was uneven according to the patients; a frank increase in the vascular volume, notably on the capillary level, and a reduction of the circulatory output (calculated on 4 distal localizations), and an increase of the interstitial compartment higher than that of the vascular volume and corresponding to the edema. These results demonstrate a circulatory stasis. In 4 patients treatment with calcitonine reduced the vascular volume but not the bone hyperfixation. In 1 patient, treatment with pindolol reduced the bone hyperfixation and the vascular volume. The authors underline the advantage of such methods in creating a better knowledge of the physiopathology of algodystrophies and effective means of treating them.

Topics: Blood Volume; Calcitonin; Cardiac Output; Diphosphates; Erythrocytes; Extracellular Space; Humans; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Technetium

Bone scintigraphy with technetium 99m pyrophosphates was used to study a series of 74 cases of algodystrophies. Though non-specific, this investigation was the determining factor for confirming the diagnosis in more than 48% of cases, by demonstrating early bone hyperfixation, its topographical characteristics, and the return to normal conditions after 3 to 12 months. Bone hyperfixation has to be exaluated together with clinical, biological, and radiological signs when considering the diagnosis, and though in half the cases it is not indispensable for diagnosis, it is always of value for determining the amount of extension of the algodystrophic process.

Topics: Adult; Aged; Bone and Bones; Diphosphates; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Technetium

In two cases, reflex sympathetic dystrophy (RSD) was due to herniated intervertebral disk at L4-5. In both cases, bone scanning with technetium 99m pyrophosphate was of value and its use is recommended in diagnosing mild or early cases of RSD. RSD may be the cause of persisting pain after disk surgery.

Topics: Diphosphates; Female; Humans; Intervertebral Disc Displacement; Male; Middle Aged; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Technetium

Topics: Bone and Bones; Diphosphates; Female; Follow-Up Studies; Foot; Fractures, Bone; Hand; Humans; Iron; Male; Middle Aged; Radiation Dosage; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Skin Temperature; Strontium Radioisotopes; Technetium

Topics: Arthritis; Bone Diseases; Bone Neoplasms; Diagnosis, Differential; Diphosphates; Hodgkin Disease; Humans; Multiple Myeloma; Neoplasm Metastasis; Osteitis Deformans; Osteoarthritis; Osteolysis; Osteomalacia; Osteoporosis; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Rheumatic Diseases; Technetium; Tin