sodium-pertechnetate-tc-99m and Arthritis

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis; Diclofenac; Female; Gamma Cameras; Humans; Methotrexate; Middle Aged; Prednisolone; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Synovitis; Temporomandibular Joint Disorders

Arthritis develops in DBA/1xB10A(4R) mice and Wistar rats upon intraplantar injection of potassium peroxochromate (K3CrO8), and is here quantified by whole blood chemiluminescence (CL) and 99mpertechnetate-imaging (99mTcO4-), and related to overt disease symptoms (the arthritis index). During the aqueous decay of K3CrO8 to chromate (VI), the chromium(V)-bound oxygen is released as superoxide, hydroxyl radicals, singlet oxygen and hydrogen peroxide, the same reactants, which are produced by activated phagocytes during inflammation. Reactive oxygen species (ROS) trigger the breakdown of the sulfhydryl-dependent antioxidant defence system and induce the nuclear factor kappa B-dependent expression of pro-inflammatory cytokines, which prime phagocytic NADPH oxidases to the enhanced production of ROS. During both the acute inflammatory response and the onset of the secondary response in non-injected paws, the phorbolester-stimulated ROS production of phagocytes was significantly enhanced (p < 0.001) and correlated well to the arthritis index (r = 0.797) and the uptake of 99mTcO4- into inflamed joints. Chromate(VI), formed during the decay of K3CrO8, contributes to the progression of arthritis by inhibition of glutathione reductase, thereby increasing intracellular H2O2 concentrations. In addition, Cr(VI) reduced to Cr(V) by ascorbate, catalyzes hydroxyl radical production in the presence of hydrogen peroxide. A stable loop forms, in which ROS, continuously produced by Cr(VI)/Cr(V) redox-cycling, drive the primary response into chronic self-perpetuating inflammation. We see the main application of K3CrO8-induced arthritis and its assessment by both 99mTcO4- imaging and chemiluminescent immunosensoring of phagocytic activity in unseparated blood as for the rapid screening of novel anti-rheumatic drugs and treatments.

Topics: Animals; Arthritis; Chromates; Disease Models, Animal; Luminescent Measurements; Male; Mice; Mice, Inbred DBA; Peroxides; Phagocytosis; Radionuclide Imaging; Rats; Rats, Wistar; Sodium Pertechnetate Tc 99m

A simplified scintigraphic technique for the assessment of sacroiliitis is described. It is based on the fact that an inflamed joint shows increased perfusion activity after administration of sodium pertechnetate. The sacroiliac joints are located by injection of a small amount of bone-seeking activity. Thereafter the pertechnetate activity is injected and the bone-seeking activity subtracted. The perfusion (pertechnetate) activity of the sacro-iliac joints is related to the activity of the large vessels of the thigh. Normal values have been established based on a study of 39 healthy controls. The method has been applied to 2 groups of patients with clinical sacroiliitis, one with and one without radiographical signs of sacroiliitis. The patients with radiographically verified sacroiliitis showed significantly higher values than the controls. The technique offers a high specificity and a high positive predictive value.

Topics: Adolescent; Adult; Aged; Arthritis; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Reference Values; Retrospective Studies; Sacroiliac Joint; Sodium Pertechnetate Tc 99m; Time Factors

The accumulation of radioactivity over rabbit knees immediately after the injection of 99mTc-pertechnetate or one of two 99mTc-labelled particulate preparations has been measured in animals with and without experimental arthritis. The results indicate that in inflamed, but not normal joints, a peak of radioactivity is detectable within 9 seconds of injection and suggest that the rate of accumulation of radioactivity over the joint may be a more sensitive indicator of inflammatory activity than measurement at a fixed time. Clearance from the circulation and tissue distribution of the three radioactive preparations were also measured.

Topics: Animals; Arthritis; Injections, Intravenous; Knee Joint; Microspheres; Rabbits; Reference Values; Sodium Pertechnetate Tc 99m; Technetium; Time Factors; Tissue Distribution

The influence of both age and sex on antigen-induced arthritis in C57Bl/10 mice was studied. Methylated bovine serum albumin was used to induce arthritis in young adult (3 months) and old (18 months) male and female mice. Arthritis became chronic and led to severe joint damage more often in 18-month-old female mice, compared with both young adult female mice and with male mice of both ages. T cell immunity and levels of antibodies against methylated bovine serum albumin were comparable in all groups. Antigen retention in the joint was greater in old compared with young adult mice of both sexes, and could therefore not entirely explain the increased prevalence of persistent arthritis in old females. Our data suggest that female hormones, in combination with age, are important factors in the chronicity and destructive character of this type of arthritis.

Topics: Age Factors; Animals; Arthritis; Arthritis, Experimental; Cartilage; Cell Survival; Edema; Estradiol; Female; Immunity; Male; Mice; Mice, Inbred Strains; Osteogenesis; Serum Albumin, Bovine; Sex Factors; Sodium Pertechnetate Tc 99m; Time Factors

Topics: Animals; Antigens; Arthritis; Focal Infection, Dental; Gingiva; Immunization; Iodine Radioisotopes; Knee Joint; Male; Mice; Mice, Inbred C57BL; Neutrophils; Radionuclide Imaging; Serum Albumin, Bovine; Sodium Pertechnetate Tc 99m

Topics: Arthritis; Diphosphates; Humans; Joints; Psoriasis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Arthritis; Diphosphates; Humans; Joints; Psoriasis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Pyrophosphate

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

A juxtaposition between the clinical-laboratory, immunologic and radionucleotide articular parameters was performed in 50 patients with psoriatic arthropathy, distributed according to the incidence of X-ray manifestations. The late and moderate changes in ESK, leukocytes, fibrinogen, DPA and phosphatasemia do not characterize the severity of the disease. A tendency to hyperuricemia and hypercalcemia is established in the period of arthralgia before the X-ray image for bone-tissue damage. The genetic HLA-B27 predetermination plays a certain role for the more frequent involvement of the spine and sacroiliac joints in the pathological process. The disturbances in the immune system are manifested with increased number of early T-lymphocytes, FcG-receptor lymphocytes, complement (C3b)--receptor lymphocytes and spontaneously blast-transformed cells. The increasing IgG content correlates with the accumulation of macromorphological X-ray images and with the index of mineral metabolism from the articular study with 99MTc-pyrophosphate. The changes in the pertechnetium index for articular vascularization are quantitatively insignificant and do not allow the joining of the psoriatic arthropathy to the group of primary synoviarthritis. The accumulation of technetium pyrophosphate in the articular structures is asymmetric, focal and precedes the changes in the X-ray image.

Topics: Adult; Alkaline Phosphatase; Arthritis; Blood Proteins; Blood Sedimentation; Calcium; Diphosphates; Female; Fibrinogen; Humans; Leukocyte Count; Male; Middle Aged; Psoriasis; Sodium Pertechnetate Tc 99m; T-Lymphocytes; Technetium; Technetium Tc 99m Pyrophosphate; Uric Acid

Ultrastructural changes of synovial capillary and venule wall have been investigated in rabbits with antigen-induced arthritis, with the permeability of microcirculatory bed determined using 99mTc pertechnetate. The correlation between the incidence of ultrastructural microvascular damages in exudative phase of arthritis and the increased permeability has been established. Ultrastructural changes occurring in proliferative phase of arthritis are considered as adaptive to conditions of increased permeability.

Topics: Animals; Arthritis; Arthritis, Experimental; Cell Membrane Permeability; Male; Microcirculation; Microscopy, Electron; Rabbits; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Synovial Membrane; Time Factors

The majority of severe haemophiliacs will develop a crippling arthritis consequent upon recurrent haemarthroses although the pathogenic mechanism remains unclear. We have carried out technetium-99 pertechnetate joint scans in the elbows, knees and ankles of 23 haemophilic patients and compared the isotope uptake of the 15 patients with clinical and radiological evidence of arthritis to that of eight patients without arthritis, to 13 age-matched healthy male controls, and to 10 age-matched males with active rheumatoid arthritis. Isotope uptake into the knee joints was significantly higher in haemophilic arthritis than in controls, haemophiliacs without arthritis, and patients with rheumatoid arthritis [median percentage uptake of administered technetium (Tc) dose X 10(3) in right knee = 9.4, 6.2, 6.4 and 6.6, respectively]: and the differences from haemophilic arthritis were all significant (p less than 0.01, Mann-Whitney U test). Similar differences were seen in the elbows and ankles. Increased Tc uptake correlated strongly with frequency of haemarthrosis, pain, synovitis, range of movement and radiological changes in knees and elbows, but poorly with the lesser changes seen in the ankles. These results would support the theory that haemophilic arthritis amongst the inflammatory arthropathies and that scanning is an appropriate technique for following progression of joint disease.

Topics: Ankle Joint; Arthritis; Arthritis, Rheumatoid; Elbow Joint; Hemophilia A; Humans; Joints; Knee Joint; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

The effects of joint inflammation on bone marrow and periarticular bone were studied in mice using antigen-induced arthritis and zymosan-induced arthritis as models for an immune and a non-immune-mediated chronic inflammation. To allow for a comparison of the two types of arthritis care was taken to induce comparable degrees of inflammation as evaluated with 99mTechnetium uptake and histology. The antigen-induced arthritis caused a significant suppression of the mitotic activity in the bone marrow close to the inflammatory focus during the first days of arthritis. The zymosan-induced arthritis did not produce alterations of the bone marrow activity. Both types of arthritis were able to induce long-lasting and irreversible damage to cartilaginous and bony structures. Apposition of bone was observed in both types of arthritis although much earlier in the antigen-induced arthritis. The apposition of bone was found to emerge largely from the periosteum and not from the epiphyseal plates, as shown by 125I-deoxyuridine autoradiography. Qualitative and quantitative differences suggest that joint inflammation which is immunologically mediated, results in more severe (peri)articular tissue damage than a non-immunological arthritis.

Topics: Animals; Arthritis; Bone and Bones; Bone Marrow; Cartilage, Articular; Deoxyuridine; Hindlimb; Joints; Male; Mice; Mice, Inbred C57BL; Mitosis; Osteogenesis; Serum Albumin, Bovine; Sodium Pertechnetate Tc 99m; Zymosan

A method is described to detect and to quantitate inflammation in knee-joints of mice. Approximately 10 muCi 99mTechnetium pertechnetate (99mTc) is injected subcutaneously in the neck region and the accumulation of the short-lived isotope in the knee-joint is detected by external gamma counting. 99mTc-uptake values correlate well with histological grading of joint inflammation at various intervals after induction of the inflammation. The method can be used to detect changes in activity of unilateral as well as bilateral joint inflammation using either the ratio of 99mTc uptake in the right knee versus that in the left knee or absolute 99mTc-uptake values.

Topics: Animals; Arthritis; Arthritis, Experimental; Histocytochemistry; Kinetics; Knee Joint; Male; Mice; Mice, Inbred C57BL; Serum Albumin, Bovine; Sodium Pertechnetate Tc 99m; Technetium

Intravenous (i.v.) administration of 300 micrograms methylated BSA (mBSA) to C57-Black mice with unilateral antigen-induced arthritis (AIA) of 4-6 weeks duration resulted in a reproducible flare-up of ongoing arthritis without signs of inflammation in the contralateral non-arthritic knee joint. In the present study we investigated characteristics of the flare-up phenomenon using histological grading and 99mtechnetium pertechnetate uptake measurements to detect and quantitate knee joint inflammation. At 6 h after intravenous mBSA administration flare-up of arthritis was demonstrable, showing histological characteristics of acute joint inflammation; later this progressed to chronic stages, but the inflammatory stage did not return to baseline values up to day 9 after i.v. challenge. Varying the dose of i.v. mBSA from 2 to 1000 micrograms showed that 10 micrograms was sufficient to elicit the phenomenon and also that the latter is dose-dependent. Using mice immunized with both mBSA and methylated HGG (mHGG) with either mBSA or mHGG-induced arthritis, we could show that 4-6 weeks after arthritis induction the flare-up phenomenon is antigen specific. Intra-articular injection of as little as 10 ng of mBSA resulted in exacerbation of inflammation in joints with chronic mBSA-induced arthritis, but induced no inflammation in the contralateral non-arthritic knee joints, indicating local hypersensitivity in the former joints. The flare-up phenomenon may be due to local hyper-reactivity of chronically inflamed joints to minimal amounts of circulating antigen entering the joint.

Topics: Animals; Antigens; Arthritis; Arthritis, Experimental; Dose-Response Relationship, Immunologic; Epitopes; gamma-Globulins; Male; Mice; Mice, Inbred C57BL; Serum Albumin, Bovine; Sodium Pertechnetate Tc 99m; Synovial Membrane; Technetium; Time Factors

Computerized, quantitative joint scintigraphies were performed using both 99mTc-MDP and 99mTc-pertechnetate. 17 joint pairs with asymmetric active arthritis were selected for the study. The joint activity ratio was calculated by dividing the curve peak value of the inflamed joint by the curve maximum of the contralateral symptomless joint. A very high joint activity ratio with 99mTc-MDP was observed in the case of septic arthritis with osteolytic lesions. In all the rheumatoid joints the activity ratios were higher with 99mTc-MDP than with 99mTc-pertechnetate. In reactive arthritis the mean joint activity ratio was equal with both tracers. It appears that 99mTc-MDP is more sensitive in detecting active rheumatoid arthritis than 99mTc-pertechnetate and that high 99mTc-MDP values might be prognostic of destructive changes.

Topics: Arthritis; Arthritis, Rheumatoid; Diphosphonates; Humans; Joints; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Medronate; Tomography, Emission-Computed

The kinetics of 99mTechnetium pertechnetate (99mTcO-4) in the rabbit knee-joint were studied by external counting of the radio-isotope after intravenous injection. We studied joints with antigen-induced arthritis in the acute and chronic phase of joint inflammation as well as non-inflamed joints. In both inflamed and non-inflamed joints, a rapid increase in radioactivity was followed by a plateau lasting for at least one hour. The time needed to reach 95% of the plateau count rate (tp) was significantly increased in inflamed as compared with non-inflamed knee-joints. Moreover, tp values were significantly higher in acutely than in chronically inflamed joints. No correlation was found between 99mTcO1 uptake and tp values. The study of kinetics of 99mTcO-4 in the rabbit knee-joint provides information additional to quantitation of inflammation by 99mTcO-1 uptake measurements, since kinetic data characterize the type of joint inflammation.

Topics: Animals; Arthritis; Knee Joint; Rabbits; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium

Radionuclide joint imaging with the technetium-99m-labeled phosphates is a sensitive technique for the detection of inflammatory articular disease, although it is nonspecific as to the cause of the increased uptake and offers poor resolution in comparison to conventional radiography. There does not appear to be any place for the routine use of joint imaging of the peripheral joints, as there is little evidence that it benefits patient management. Scintigraphy is of benefit in the detection of osteomyelitis, Legg-Perthes' disease, and osteonecrosis, where changes may antedate roentgenologic abnormalities. Technetium-99m-phosphates may have an increasing role in the evaluation of knee and hip prosthetic joint loosening and infection, especially regarding the femoral components. Scintigraphy may be useful in excluding synovitis and allaying concern in selected patients with chronic articular pain in whom a conventional diagnostic evaluation is unrewarding. Attempts have been made to use radionuclide joint imaging to quantitate the degree of synovitis present in individual joints, particularly the sacroiliac joints. To date, reliable methods that distinguish normal from abnormal joints have not been established, although this remains an area of potential usefulness and active research. Scintigraphy with 99mTc-phosphates is useful in the detection of spinal fracture and pseudoarthrosis in individuals with ankylosing spondylitis.

Topics: Adult; Arthritis; Bone Neoplasms; Child; Diphosphates; Diphosphonates; Female; Gallium Radioisotopes; Humans; Joint Diseases; Legg-Calve-Perthes Disease; Male; Middle Aged; Osteoarthritis; Osteomyelitis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spondylitis, Ankylosing; Synovitis; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

We studied (i) the inflammatory response induced by intra-articular (i.a.) injection of 2.5 and 0.5 mg 125I-labelled bovine serum albumin (125I-BSA) into the paired knee joints of rabbits immunized with BSA in Freund's complete adjuvant, and (ii) handling of these different doses of antigen by means of regular external radioactivity measurements. The joint inflammation was quantified by 99mTechnetium pertechnetate uptake measurements. More severe arthritis was seen in the 2.5 mg BSA-injected than in the paired 0.5 mg BSA-injected knee, both in the early and in the late phase of antigen-induced arthritis. External radioactivity measurements showed enhanced disappearance of radioactivity from the 2.5 mg 125I-BSA challenged knee joint, resulting in lower percentual retention of the dose injected than in the 0.5 mg injected knee joint. However the calculated absolute amount of long term retained BSA in the 2.5 mg BSA injected knee, 4 weeks after i.a. injection, was still about 2.8 times the quantity of BSA retained in the 0.5 mg BSA-injected paired knee joint. These data indicate that the severity of both the early and late phase of antigen-induced arthritis is i.a. antigen dose-dependent and, in addition, suggest that handling of i.a. antigen depends in part on the severity of joint inflammation.

Topics: Animals; Antigens; Arthritis; Arthritis, Experimental; Dose-Response Relationship, Immunologic; Female; Hindlimb; Injections, Intra-Articular; Joints; Male; Rabbits; Serum Albumin, Bovine; Serum Albumin, Radio-Iodinated; Sodium Pertechnetate Tc 99m; Technetium

Data are summarized indicating that the degree and duration of antigen induced arthritis (AIA) influences handling of intra-articular (i.a.) antigen. Long term antigen retention was less in chronic as compared with transient joint inflammation, whereas i.a. antigen was cleared more rapidly from the joint in severe than in moderate AIA. In addition, the presence of ungoing AIA enhances initial elimination of i.a. injected antigen from the joint.

Topics: Animals; Antigens; Arthritis; Freund's Adjuvant; Inflammation; Injections, Intra-Articular; Iodine Radioisotopes; Rabbits; Radionuclide Imaging; Serum Albumin, Bovine; Sodium Pertechnetate Tc 99m

An animal model of arthritis in the rabbit was employed to assess the radioactivity contribution of joint tissues to externally monitored scintigram positivity. Bone contained the greatest total amount of radioactivity whether the imaging agent was technetium pertechnetate or pyrophosphate, although the greatest percent increase in the arthritis joints over control joints was seen in synovium. Mid-shaft bone in the same region as the arthritic joint also showed increased radioactivity compared with control.

Topics: Animals; Arthritis; Diphosphates; Disease Models, Animal; Evaluation Studies as Topic; Femur; Injections, Intra-Articular; Knee Joint; Rabbits; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Synovial Fluid; Synovial Membrane; Technetium; Technetium Tc 99m Pyrophosphate; Tissue Distribution

We adapted the method of 99mTc-pertechnetate (99mTc) uptake measurements to the mouse knee for detection and quantification of arthritis because clinical assessment of mouse knee-joint arthritis is not reliable. The main points to ensure reproducibility of measurements were proper fixation and positioning of the knee and careful shielding of the rest of the body from the gamma-radiation detector. 99mTc uptake was calculated as the mean of three countings. The variation coefficient of these countings ranged from 0.007 to 0.082 in non-arthritic joints and from 0.025 to 0.081 in arthritic joints. Arthritis was scored as the ratio of the 99mTc uptake in the right knee versus that in the left knee. This ratio averaged 1.06 (S.D. 0.05) in non-arthritic mice 20 minutes after 99mTc administration i.p. On the second day after induction of arthritis in the right knee, this ratio ranged from 1.44 to 1.96; this was significantly higher (P less than 0.005) than in non-arthritic mice, and the increase remained significant during at least 20 days. 99mTc uptake measurements seem to be a useful method to detect and quantify arthritis of the knee joint in mice.

Topics: Animals; Arthritis; Arthritis, Experimental; Kinetics; Knee Joint; Male; Mice; Mice, Inbred C57BL; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium