technetium-tc-99m-medronate and Ankle-Injuries

Sinus tarsi syndrome is a pain in the lateral side of the hind foot that is responsive to injection of local anesthetic agents. We report a case of a 42-year-old man who presented with pain over the lateral aspect of the right foot. Laboratory investigations and x-ray were normal. Bone scintigraphy showed hyperemia and increase tracer uptake in right hind foot. SPECT-CT localizes this uptake at the inferior aspect of the talus and superior aspects of the calcaneus. Diagnosis of sinus tarsi syndrome was made on the basis of history, clinical examination, and bone scintigraphy findings. Local conservative therapy was initiated.

Topics: Adult; Ankle Injuries; Foot Injuries; Humans; Male; Multimodal Imaging; Radiopharmaceuticals; Syndrome; Tarsal Bones; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

To evaluate the role of 99m-technetium methylene diphosphonate (Tc-99m MDP) bone scintigraphy on the detection of joint damage in asymptomatic alpine ski racers.. This study included 20 male asymptomatic alpine ski racers (age range: 18-21 years). None of the skiers had a history of ski crashes. Bone scan findings of the racers were examined with Tc-99m MDP bone scintigraphy during the active racing season and the inactive training season. Planar anterior and posterior images of hip, knee, and ankle joints were obtained 4 h after intravenous injection of 20 mCi Tc-99m MDP. All images were interpreted visually by 2 experienced nuclear medicine physicians. Free regions of interest were drawn on hip, knee, and ankle joints, as well as background regions. Joint-to-background ratios were calculated for each joint, and the uptake ratios of both right and left joints during active ski season were compared to those during the inactive training period.. Uptake ratios of the right and left hip, knee, and ankle joints were significantly higher during the active racing period than those calculated during the inactive period (P < 0.005).. Bone scintigraphy may have an important role in detecting joint injuries of hip, knee, and ankle joints in asymptomatic alpine ski racers and can be used successfully when MRI is unavailable.

Topics: Adolescent; Adult; Ankle Injuries; Asymptomatic Diseases; Hip Injuries; Humans; Knee Injuries; Lower Extremity; Male; Radionuclide Imaging; Radiopharmaceuticals; Skiing; Technetium Tc 99m Medronate; Young Adult

Ankle sprains are a common injury and may occur in as many as 75% of sporting participants. More complex injuries involving a rotational component may lead to injury of the interosseous membrane, its supporting ligaments, or the tibial plafond, compromising the integrity of the ankle mortice. Four such cases that show the scintigraphic manifestation of the injury are presented. In addition to the standard planar views of the ankles, special magnified anterior views were obtained with the feet in internal rotation of 25 degrees to 35 degrees. These special views facilitated the diagnoses.

Topics: Adolescent; Adult; Ankle Injuries; Athletic Injuries; Female; Humans; Ligaments, Articular; Male; Military Personnel; Radionuclide Imaging; Radiopharmaceuticals; Soccer; Sprains and Strains; Technetium Tc 99m Medronate

Scintigraphy is an established imaging technique for injuries of the ankle and foot that are not apparent on plain radiographs. The scintigraphic technique has varied, with planar and pinhole images being used.. The incremental value of pinhole scintigraphy over planar imaging was studied in 16 patients with established diagnoses. Inter-reporter reproducibility was also measured.. Pinhole scintigraphy improved the diagnostic specificity in nearly one half of the patients (48%). It did not contribute substantial information in 46% and led to confusion in the diagnosis of one patient. Inter-reporter agreement was good, with a kappa value of 0.78. Diagnoses varied from fractures of the talar dome to avulsion fractures of the malleoli and impingement syndromes.. Pinhole images add a significant incremental value to planar scintigraphy of the foot and ankle. Although this had been perceived intuitively in the past, it has not been critically evaluated. The technique has good inter-reporter agreement.

Topics: Adolescent; Adult; Ankle Injuries; Child; Female; Foot Injuries; Fractures, Bone; Humans; Image Enhancement; Male; Observer Variation; Photography; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Retrospective Studies; Technetium Tc 99m Medronate

Topics: Adolescent; Ankle Injuries; Female; Fractures, Bone; Humans; Radionuclide Imaging; Radiopharmaceuticals; Swimming; Syndrome; Talus; Technetium Tc 99m Medronate

Pyomyositis, although uncommon, is being reported with greater frequency in temperate climates. The presentation is similar to a number of infectious processes, and when associated with a traumatic event, the clinical picture may be confused with that of a musculoskeletal injury. This, coupled with an unfamiliarity of the disease, may result in a delay in diagnosis. Early antibiotic therapy may obviate surgery. Progression to the suppurative stage requires surgical drainage along with antibiotics. CT guided drainage may be accomplished in certain cases. In immunocompromised patients, progression to the septicemic stage is associated with high morbidity and mortality.

Topics: Ankle Injuries; Biopsy; Child; Combined Modality Therapy; Compartment Syndromes; Debridement; Decompression, Surgical; Diagnostic Errors; Disease Progression; Emergency Treatment; Female; Humans; Myositis; Nafcillin; Necrosis; Osteomyelitis; Penicillins; Staphylococcal Infections; Suppuration; Technetium Tc 99m Medronate

Topics: Adult; Ankle Injuries; Contusions; Female; Humans; Joint Diseases; Radionuclide Imaging; Tarsal Bones; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Technetium-99m hydroxymethylene diphosphonate scans were performed on 29 consecutive patients with acute ankle ligament injuries. Scanning reliably differentiated a severe from a minor injury. Severe injuries gave a diffuse uptake on the scan and the minor injuries a more localized increase in uptake.

Topics: Adolescent; Adult; Aged; Ankle Injuries; Ankle Joint; Female; Humans; Ligaments, Articular; Male; Middle Aged; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Ballet dancers are athletes susceptible to ligamentous and bony injury. We reviewed retrospectively the bone scans (technetium-99m methylene diphosphonate) of 23 ballet dancers with pain in the back and/or lower extremities to determine the usefulness of scintigraphy in the detection of stress lesions of bone. The scintigraphic studies in 19 dancers identified multiple areas of stress injury in both symptomatic and asymptomatic locations. Thirteen dancers had 22 stress fractures (microfractures of trabeculae with associated bone repair) manifested by an intense focus of increased uptake of radiopharmaceutical, and 19 dancers had stress reactions (areas of accelerated remodeling and resorption of bone) demonstrated by diffusely increased uptake of radiotracer. Ten of the 13 dancers with stress fractures were symptomatic and six of the 19 dancers with stress reactions were symptomatic. The radiographs of 10 dancers with positive bone scans were normal or showed no distinction between acute and chronic injuries. Stress fractures were most prevalent in the feet, and stress reactions were most prevalent in the tibiae. The study confirmed that ballet dancers sustain significant bone stress in their legs and feet. Our results show that scintigraphy can be used to detect stress fractures and stress reactions at both symptomatic and asymptomatic sites in this population.

Topics: Adolescent; Adult; Ankle Injuries; Bone and Bones; Child; Cumulative Trauma Disorders; Dancing; Female; Fibula; Fractures, Bone; Humans; Leg Injuries; Male; Metatarsal Bones; Middle Aged; Pain; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Medronate; Tibia

Topics: Adolescent; Ankle Injuries; Diphosphonates; Female; Fractures, Bone; Humans; Pain; Radionuclide Imaging; Talus; Technetium; Technetium Tc 99m Medronate