technetium-tc-99m-medronate and Arthritis--Reactive

Stress fractures are the injuries of soft tissues and bones caused by intensive and repeated stress on a bone. Repeated submaximal stress disturbs the balance between the processes of bone production and resorption that results in fracture.. We presented a case of a patient with stress fracture of metatarsal bone. The patient was diagnosed and treated as having reactive oligoarthritis caused by Chlamydia trachomatis and administered antibiotics. Initial plain radiography was negative for bone fracture. Tc-99m bone scintigraphy suggested stress fracture of the second metatarsal. Plain radiography was became positive three weeks later, showing callus formation in the proximal part of the second metatarsal.. Bone scintigraphy is a diagnostic test of choice in early diagnosis of stress fracture, and it is important to apply it timely in order to include the entire therapy and prevent complications, as well as to let a patient return to previous daily activities.

Topics: Adult; Arthritis, Reactive; Chlamydia Infections; Chlamydia trachomatis; Diagnosis, Differential; Fractures, Stress; Humans; Male; Metatarsal Bones; Military Personnel; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Yugoslavia

Topics: Adolescent; Adult; Arthritis, Reactive; Bone and Bones; Female; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Rheumatic Diseases; Technetium Tc 99m Medronate

Tc-99m MDP bone scans were used to evaluate the articular inflammation in 38 patients with Reiter's disease and compared with clinical examination and radiologic findings. Our data showed that Reiter's disease predominantly involves the lower limbs, especially the heels, which may be a characteristic feature of Reiter's disease. Bone scans revealed a high diagnostic sensitivity in the detection of clinical arthritis in all peripheral joints, especially in the small joints of the four limbs. The diagnostic sensitivity of radiography was generally lower than bone scintigraphy. In the presence of positive radionuclide findings, clinical arthritis was found in most joints. The scintigram, however, detects a greater number of abnormalities than does clinical assessment in the sternoclavicular joints, shoulders, metacarpophalangeal joints, and tarsals. Because of its high sensitivity, bone scintigraphy is capable of detecting subclinical arthritis, and might provide more objective evidence of early inflammatory joint disease and additional information regarding the pattern of joint involvement. In view of the advantages of low patient radiation exposure, high sensitivity, and the ability to survey the whole body, we consider bone scintigraphy as useful and better than radiography in the detection of early articular inflammation and in establishing the extent and pattern of arthritis in Reiter's disease.

Topics: Adolescent; Adult; Aged; Arthritis, Reactive; Bone and Bones; Female; Humans; Male; Middle Aged; Physical Examination; Radiography; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate

Tc-99m MDP bone scans were used to evaluate the heel pain (talalgia) in 38 patients with Reiter's disease, and compared with clinical examination and radiologic findings. In our work, 58% (22/38) patients presented talalgia with a total of 35 lesions. Only two lesions of clinical talalgia were missed by the bone scan. The diagnostic sensitivity was as high as 94% (33/35). However, the diagnostic sensitivity of radiography was only 69% (11/16) when the disease duration was more than one year; furthermore, it declined to 33% (4/12) when the disease duration was less than one year. Based on the bone scans, the correlation between positive scintigraphic findings and clinical talalgia was extremely good. Clinical talalgia occurred in all the 33 lesions demonstrated by bone scan. However, three lesions demonstrated by radiography were not consistent with clinical talalgia and not visualized by radioscintigraphy. Our data show that the radionuclide scan is a more sensitive indicator and has better correlation with clinical talalgia than radiography. We consider that bone scintigraphy is superior to radiography in the evaluation of heel pain in Reiter's disease.

Topics: Adolescent; Adult; Aged; Arthritis, Reactive; Female; Heel; Humans; Male; Middle Aged; Pain Measurement; Radiography; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate; Time Factors

Topics: Adult; Aged; Arthritis, Reactive; Diphosphonates; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Sacroiliac Joint; Sacrum; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Medronate

Methodological aspects of quantitative sacroiliac scintigraphy (QSS) using [99mmTc]methylene diphosphonate (MDP) were studied. To improve the diagnostic value of QSS it is important to understand the errors involved in the calculated indices. The accumulated radioactivity in the sacro-iliac joint, compared with that in the sacral bone (SI ratio), decreased linearly with age, by about 24% from the age of 15 years to 71 years. The post-injection time of scintigraphy was not critical, if the scintigraphy was carried out after 2.5 hours. Although the variances of the SI ratios in our control material were relatively high, the repeatability of the SI ratio measurement was 3.9%. The influence of measuring geometry on the QSS and the acceptability of the sacrum as the reference area were tested.

Topics: Adolescent; Adult; Aging; Arthritis, Reactive; Diphosphonates; Female; Functional Laterality; Humans; Male; Methods; Middle Aged; Psoriasis; Radionuclide Imaging; Regression Analysis; Sacroiliac Joint; Sex Factors; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Medronate