sodium-pertechnetate-tc-99m and Osteoarthritis

Two potentially chondro-protective substances are compared with each other: polymeric chondroitin sulfate and monomeric glucosamine. Chondroitin-sulfate is characterized by tropism for cartilage, i.e. it is preferentially incorporated into cartilagenous tissue. This quality could be of interest in the SPECT-analysis of osteoarthritic knee joints. In contrast to the classic agents Ibuprofen and Indomethacin, the antiinflammatory action of chondroitin-sulfate is less prominent, but the drug does not show any toxic side effects. Glucosamine on the other hand is a multifunctional precursor of the glycosaminoglycan synthesis in general. It lacks the cartilage tropism of chondroitin-sulfate. Into what sort of a glycosaminoglycan glucosamine is eventually integrated, depends therefore on the nature of the cells participating in the biosynthesis.

Topics: Aggrecans; Chondroitin Sulfate Proteoglycans; Chondroitin Sulfates; Extracellular Matrix Proteins; Glucosamine; Humans; Lectins, C-Type; Menisci, Tibial; Osteoarthritis; Proteoglycans; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Synovial Fluid; Tomography, Emission-Computed, Single-Photon

The potential of scintigraphy with technetium 99m-labelled J001 (99mTc-J001) to detect synovitis was studied in 15 rabbits with osteoarthritis (OA) of the right knee (section of cruciate ligaments), in five sham-operated rabbits and in four non-operated rabbits. J001 is a non-pyrogenic, acylated poly (1,3) galactoside isolated from the membrane of a non-pathogenic strain of Klebsiella pneumoniae which is able to bind selectively to macrophages via the binding to CD11b and CD14 molecules. The results of 99mTc-J001 scintigraphy were compared with those of scintigraphy with 99mTc-labelled methylene diphosphonate (99mTc-MDP) and GC-APG (a derivative of J001 unable to bind macrophages in vitro). The mean scintigraphic ratios (diseased healthy knee) of 99mTc-J001 were significantly higher in OA rabbits than in sham- and non-operated rabbits, from as early as day 18 until day 90. 99mTc-J001 scintigraphy demonstrated earlier increased uptake than 99mTc-MDP scintigraphy. The mean scintigraphic ratios of 99mTc-J001 were significantly higher than those of 99mTc-GC-APG (which remained normal) in OA rabbits. The normal scintigraphic ratios of 99mTc-J001 in sham-operated and non-operated rabbits, as well as of 99mTc-GC-APG in OA rabbits, suggested that the increased uptake demonstrated with 99mTc-J001 in OA rabbits, as early as day 18 corresponded to imaging of synovitis via elective macrophage targeting. These results showed that 99mTc-J001 scintigraphy should be a specific method of detecting synovitis in OA.

Topics: Animals; Anterior Cruciate Ligament; CD11 Antigens; Lipopolysaccharide Receptors; Macrophages; Male; Osteoarthritis; Posterior Cruciate Ligament; Rabbits; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Synovitis; Technetium Tc 99m Medronate

Osteoarthritis was induced in 30 adult rats by serial injection of papain (3.5 mg kg-1) into the right knee on days 1, 4 and 7 of the study, with equal volumes of normal saline being injected into the left knee as a control. The severity of the induced arthritis was observed after the subcutaneous injection of 37 MBq kg-1 (1 mCi kg-1) 99Tcm-pertechnetate in the neck 24 h and 1, 2, 4, 6 and 8 weeks after the first intra-articular injection of papain. The ratio of radioactivity in the right compared with the left knee of each rat was measured as an index of the severity of osteoarthritis. After the scans, X-rays of both knees were obtained. At each state of progression, a rat was sacrificed and bilateral knee sections were performed for further pathological evaluation. The results were then compared with the changes in the radioactivity ratio and the X-rays. The radioactivity ratio of the knees reached a peak approximately 25 min after the subcutaneous injection of 99Tcm-pertechnetate and this value was chosen as the index of the severity of osteoarthritis. Marked differences in radioactivity in the left and right knees were observed as early as 24 h after the first intra-articular injection of papain. The radioactivity ratio increased with time, which correlated well with pathological changes. Joint space narrowing was not found on X-ray until 4 weeks post-injection. The results showed that the 99Tcm-pertechnetate scans correlated well with the pathological changes and that this method can detect osteoarthritis earlier than joint X-rays. It is suggested that a 99Tcm-pertechnetate scan is a useful means of evaluating early changes in induced osteoarthritis in rats.

Topics: Animals; Female; Joints; Osteoarthritis; Papain; Radionuclide Imaging; Rats; Rats, Wistar; Reference Values; Sodium Pertechnetate Tc 99m; Time Factors

This study was undertaken to evaluate the use of Indium-111-labeled leukocyte (111In-WBC) imaging compared with Technetium-99m pertechnetate (99mTcO4-) imaging in 19 patients with rheumatoid arthritis (RA) and 8 with osteoarthritis. Knee and wrist joints were evaluated for both radionuclides. The results indicated a good correlation of the clinical assessment of pain and swelling with joint uptake ratio (JUR) between 111In-WBC and 99mTcO4- in RA and osteoarthritis patients. We observed a discrepancy in both imagings in "burned out" cases. It was concluded that a JUR of 111In-WBC could distinguish active RA from inactive RA or osteoarthritis at a value of 1.15 and that the use of 111In-WBC was a more reliable procedure than 99mTcO4-.

Topics: Adult; Aged; Arthritis, Rheumatoid; Female; Humans; Indium Radioisotopes; Knee Joint; Leukocytes; Male; Middle Aged; Osteoarthritis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Wrist Joint

Topics: Ankle Joint; Calcaneus; Child; Female; Humans; Osteoarthritis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Application of scintigraphic techniques, especially bone scintigraphy, to a group of unselected psoriatic patients provided us with new knowledge about frequency, dimension, and valence of psoriatic osteoarthropathy. Thus scintigraphy was able to prove up to 90% of the incidences, whereas clinical and radiological investigation only revealed 7%. This result was achieved on account of better registration of the polytopical character as well as the evidence of potential early manifestations which could not be detected clinically or radiologically. In addition, we proved extraarticular manifestations of psoriatic osteopathy, especially in the skull, the long marrow bones, the ribs, and the distal phalanges.

Topics: Bone and Bones; Collagen; Humans; Joints; Osteoarthritis; Phosphates; Psoriasis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Compounds

Forty-nine patients were studied prospectively by salivary scanning to assess the value of this investigation in possible Sjögren's syndrome (SS). Twenty-three had rheumatoid arthritis (RA) with sicca symptoms and a positive Schirmer's test. Fifteen had RA with no sicca symptoms and a negative Schirmer's test. Eleven had osteoarthrosis (OA) with no sicca symptoms and a negative Schirmer's test. Scanning differentiated only poorly between the three groups. We conclude that it has only limited application in the diagnosis of SS associated with RA.

Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Osteoarthritis; Parotid Gland; Radionuclide Imaging; Salivary Glands; Sjogren's Syndrome; Sodium Pertechnetate Tc 99m; Submandibular Gland; Technetium; Thyroid Gland; Xerostomia

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

Serum enzymes and articular radionuclide tests have a restricted application in solving the current diagnostic and differential-diagnostic problems of present-day rheumatology. The enzyme tests became positive in case of a high activity of rheumatoid arthritis, not objectivizing the articular degeneration. Their correlation with radionuclide tests of the patients with osteoarthrosis and the patients with rheumatoid arthritis is not elucidated. A juxtaposition was made of the serum enzymes with the articular radionuclide quantitative indices in 88 patients with rheumatoid arthritis with various clinical-laboratory activity, 88 patients with osteoarthrosis in various X-ray stages and 22 healthy controls. A correlation dependence was established between LDH, CPK, acid phosphatase, clearance effectiveness of articular cavity and the deposition of 99mTc-pyrophosphate in knee joints of the patients with osteoarthritis and between gamm-GT, alkaline phosphatase, acid phosphatase and radionuclide articular indices of the patients with rheumatoid arthritis. Those characteristics enabled the earlier overcoming of the diagnostic difficulties in those two basic rheumatic diseases.

Topics: Adult; Arthritis, Rheumatoid; Clinical Enzyme Tests; Diphosphates; Enzyme Activation; Humans; Knee Joint; Middle Aged; Osteoarthritis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Pyrophosphate; Xenon Radioisotopes