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

Topics: Aged, 80 and over; Athletic Injuries; Bone Neoplasms; Exercise; Humans; Male; Muscles; Prostatic Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Athletic Injuries; Cumulative Trauma Disorders; Female; Humans; Middle Aged; Muscle, Skeletal; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Thigh

Skeletal scintigraphy is an important method for showing evidence of stress injuries affecting the partes interarticulares of young athletes with low back pain. Other etiologies of low back pain may also cause uptake abnormalities in these patients. How often do the results of skeletal scintigraphy support diagnoses other than stress injuries to the partes interarticulares and what are these diagnoses?. We retrospectively reviewed the records of 209 young patients (149 females, 60 males; age range: 8-21 years, mean: 15.7 years) with low back pain and no previously treated vertebral condition who were consecutively referred from a sports medicine clinic to skeletal scintigraphy.. Sites of high uptake supportive of diagnoses other than pars interarticularis stress were shown in 36 (17%) of the 209 patients. Other diagnoses supported by skeletal scintigraphy included stress at the articulation between a transitional vertebra and the sacrum, injuries to the vertebral body ring apophysis, sacral fracture, spinous process injury, and sacroiliac joint stress.. Skeletal scintigraphy shows uptake abnormalities supportive of diagnoses other than pars interarticularis stress in a significant number of young patients with low back pain. The uptake abnormalities shown are usually stress-related in this select population.

Topics: Adolescent; Adult; Athletic Injuries; Female; Fractures, Stress; Humans; Low Back Pain; Lumbar Vertebrae; Male; Radiopharmaceuticals; Retrospective Studies; Sacrum; Spinal Fractures; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Topics: Athletic Injuries; Femur; Humans; Knee Joint; Muscle, Skeletal; Muscular Diseases; Periostitis; Radioisotopes; Rheumatic Diseases; Running; Syndrome; Technetium Tc 99m Medronate; Tomography, Emission-Computed

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

Stress-related injuries have been reported for numerous forms of exercise and sport. The patterns of injury and the incremental value of specially developed views were retrospectively reviewed at the end of three successive playing seasons of Australian football. The primary sites of clinical trauma were imaged, as were immediately adjacent bones and joints in order to assess concurrent trauma, and an attempt was made to evaluate the need to extend the area of scanning. Of the injuries detected, 67% of the total occurred at or below the level of the knee. Fifty-five per cent of these injuries occurred in the tibiae, fibulae and bones of the foot in a pattern reflecting the nature of the traumatic insult recurring in this particular sport. An incremental value of 28% was found for the specially developed views. Clinically unsuspected pathology was found in 54% of cases.

Topics: Adult; Athletic Injuries; Bone and Bones; Gamma Cameras; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Sports; Technetium Tc 99m Medronate

Topics: Adult; Athletic Injuries; Fractures, Stress; Humans; Leg Injuries; Male; Radionuclide Imaging; Radiopharmaceuticals; Running; Sprains and Strains; Technetium Tc 99m Medronate; Tibial Fractures

Topics: Adolescent; Athletic Injuries; Back Pain; Fractures, Stress; Humans; Radionuclide Imaging; Radiopharmaceuticals; Spinal Fractures; Technetium Tc 99m Medronate; Thoracic Vertebrae

This study compares the bone scan appearances in 32 patients with medial tibial syndrome (MTS) with the appearance in 28 patients with confirmed chronic compartment syndrome (CCS). A distinctive pattern of uptake was seen in 30 patients, 24 of whom had MTS and 6 of whom had CCS. Of the patients with normal scans, only 4 had MTS, the remaining 15 had CCS. Both of these findings are statistically significant and confirm that bone scans are a useful diagnostic tool in the differential diagnosis of exercise-induced lower leg pain.

Topics: Adult; Anterior Compartment Syndrome; Athletic Injuries; Diagnosis, Differential; Exercise; Female; Fractures, Stress; Humans; Male; Pain; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate; Tibia

Twelve athletes presenting acute knee injury with normal radiological findings underwent both three-phase radionuclide bone imaging (TPBI) and magnetic resonance imaging (MRI). The association of these highly sensitive diagnostic procedures detected occult fractures in all patients. The areas of signal intensity alterations on MRI corresponded to those of increased radionuclide uptake in blood pool images. However, the same areas seemed to be more extended on delayed TPB images. TPBI yielded early diagnostic information about lesion sites and functional activities, while MRI provided better anatomical definition and specific information about associated soft tissue lesions and served to establish the correct therapeutic approach and follow-up.

Topics: Adolescent; Adult; Athletic Injuries; Female; Femoral Fractures; Humans; Knee Injuries; Magnetic Resonance Imaging; Male; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tibial Fractures

Topics: Adult; Athletic Injuries; Diagnosis, Differential; Fractures, Stress; Humans; Lumbar Vertebrae; Male; Spinal Fractures; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Topics: Adult; Arm Injuries; Athletic Injuries; Female; Humans; Radionuclide Imaging; Technetium Tc 99m Medronate

Bone scintigraphy is used to detect radiographically silent fractures. Magnetic resonance imaging (MRI) is currently used to screen knee injuries for cartilage and ligament damage. MRI also delineates bone marrow and fractures. We investigated the bone scintigraphic findings in patients who had subchondral bone injuries demonstrated on MRI. Thirteen patients underwent MRI, three-phase bone scintigraphy with SPECT, and arthroscopic surgery after sustaining acute traumatic hemarthrosis of a knee. They all had clinically unsuspected subchondral bone injuries demonstrated on MRI with normal radiographs and normal overlying articular cartilage at arthroscopy, consistent with occult fractures. All showed focal bone repair on scintigraphy. Two of the 13 patients showed additional bone injuries only on bone scan. Two other patients scintigraphically showed focal bone repair at the medial femoral condyle due to avulsion of the medial collateral ligament. SPECT was easier to interpret than multi-view planar imaging. Bone scintigraphy confirms subchondral fractures demonstrated on MRI but also demonstrates ligament avulsion injuries and additional more subtle bone injuries.

Topics: Adolescent; Adult; Athletic Injuries; Female; Fractures, Bone; Humans; Knee Injuries; Ligaments, Articular; Magnetic Resonance Imaging; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

In the assessment of acute knee pain following recent trauma frequently related to sporting activities, bone scintigraphy was performed on 52 patients; in 40 of these patients, scintigraphy immediately preceded arthroscopy. SPECT was critical in providing delineation and sitting of the abnormalities; this would not have been feasible with conventional planar imaging in 45 of the patients. Multiple sites of focal uptake were frequently visualized at ligamentous insertions or in intra-articular areas of cartilaginous erosion. Damaged anterior cruciate ligaments were only identified in 5 out of 10 patients, occurring when there was avulsion of the tibial attachment, but changes resulting from patellar injury were demonstrated in all 8 patients. The most characteristic scintigraphic change resulted from meniscal tears, which was diagnosed in 31 out of 35 patients in whom the lesion had been suspected clinically. In the identification of this common injury, SPECT had a sensitivity of 88%, specificity of 87%, and diagnostic accuracy of 88%. Thus, although trauma readily induces scintigraphic abnormalities in and around the knee, the patterns of alteration associated with particular lesions can be identified by SPECT and can provide considerable assistance in management, particularly in determining the need for arthroscopy.

Topics: Anterior Cruciate Ligament Injuries; Arthroscopy; Athletic Injuries; Female; Fractures, Stress; Humans; Knee; Knee Injuries; Male; Patella; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tibial Meniscus Injuries; Tomography, Emission-Computed, Single-Photon

An 11-year-old boy had bone scanning to rule out an osseous lesion of the right arm. He presented progressive pain and hard swelling of the right arm. His past medical history and general physical examination were unremarkable. He trained for karate. The scan demonstrated considerable muscular uptake in both arms. CPK and CPK MB levels were both abnormally high, suggesting muscle injury. After a 10-day rest period the bone scan returned to normal.

Topics: Arm Injuries; Athletic Injuries; Bone and Bones; Child; Humans; Male; Muscles; Radionuclide Imaging; Technetium Tc 99m Medronate

A case of fracture of the right scapula in the superomedial portion with no history of direct trauma is presented. It is most likely due to jogging with weights in both hands. A brief review of scapular fractures is also reported.

Topics: Adult; Athletic Injuries; Cumulative Trauma Disorders; Fractures, Bone; Humans; Jogging; Male; Radionuclide Imaging; Running; Scapula; Technetium Tc 99m Medronate; Weight Lifting

Thirty-three patients attending the Nottingham Sports Injury Clinic in whom a clinical diagnosis of a stress fracture of the pars interarticularis was made were evaluated with both radiography and bone scintigraphy. This was done in an effort to distinguish a recent stress fracture which would produce a positive scintigram from an established 'incidental' spondylolysis giving a normal scintigram. Nine patients demonstrated abnormal radiography with a normal scintigram. A further nine patients had a positive scintigram. Six were associated with a spondylolysis indicating a recent stress fracture but two had normal radiography suggesting a stress fracture in the 'sub-radiological' phase. One patient had increased uptake in relation to degenerative changes of the lower lumbar facet joints. Oblique views of the scintigram helped in localisation of the abnormal uptake to the pars interarticularis.

Topics: Adolescent; Adult; Athletic Injuries; Cumulative Trauma Disorders; Football; Fractures, Bone; Humans; Lumbar Vertebrae; Radiography; Radionuclide Imaging; Skiing; Spondylolisthesis; Spondylolysis; Technetium Tc 99m Medronate

Topics: Accidental Falls; Athletic Injuries; Child; Diagnosis, Differential; Fractures, Bone; Humans; Lumbar Vertebrae; Male; Radiography; Radionuclide Imaging; Spinal Injuries; Spine; Technetium Tc 99m Medronate; Thoracic Vertebrae

Topics: Adolescent; Adult; Athletic Injuries; Cumulative Trauma Disorders; Female; Fractures, Bone; Humans; Leg Injuries; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

We examined 26 athletes with continued pain after strenuous exercise. We found stress fractures in 15 patients, all of whom had positive roentgenographic studies. Seven of these 15 also had bone scans, all of which were positive. Five patients had stress reactions, all of which showed positive results on bone scan and negative roentgenographic results. Five had occult stress reactions manifested by pain, with normal roentgenographic and scintigraphic results, and one had minor pain not requiring radiologic studies. Stress reaction is contrasted with stress fracture by demonstrating the role of bone imaging in the diagnostic continuum of stress reaction to stress fracture.

Topics: Adult; Athletic Injuries; Extremities; Female; Follow-Up Studies; Fractures, Bone; Humans; Male; Pain; Pain Management; Radiography; Radionuclide Imaging; Stress, Mechanical; Technetium Tc 99m Medronate; Wound Healing

Topics: Adolescent; Athletic Injuries; Football; Fractures, Spontaneous; Humans; Male; Radionuclide Imaging; Technetium Tc 99m Medronate; Tibia; Tibial Fractures

Bone imaging has been recognized as a useful diagnostic tool in detecting the presence of focal musculoskeletal injury when radiographs are normal. A retrospective review of bone images in a small number of amateur athletes indicates that secondary injuries were commonly detected at sites different from the site of musculoskeletal pain being evaluated for injury. While a larger study will be necessary to confirm the data, this review suggests that it is medically justified and cost-appropriate to perform imaging of the entire skeleton as opposed to imaging limited to the anatomic site of pain and suspected injury.

Topics: Adolescent; Adult; Athletic Injuries; Bone and Bones; Cost-Benefit Analysis; Female; Fractures, Bone; Humans; Male; Radionuclide Imaging; Retrospective Studies; Sports; Stress, Mechanical; Technetium Tc 99m Medronate

Topics: Adolescent; Athletic Injuries; Female; Humans; Leg Injuries; Muscles; Radionuclide Imaging; Running; Technetium Tc 99m Medronate

Three-phase radionuclide bone (TPB) imaging was performed on 238 patients with sports-related injuries. A wide variety of lesions was encountered, but the most frequent lesions seen were stress fractures of the lower part of the leg at the junction of the middle and distal thirds of the posterior tibial cortex (42 of 79 lesions). There were no differences in the type, location, or distribution of lesions between males and females or between competitive and noncompetitive athletes. In 110 cases, bone stress lesions were often diagnosed when radiographs were normal, whereas subacute or chronic soft-tissue abnormalities had few specific scintigraphic features. TPB imaging provides significant early diagnostic information about bone stress lesions. Normal examination results (53 cases) exclude underlying osseous pathologic conditions.

Topics: Adolescent; Adult; Aged; Athletic Injuries; Back Pain; Bone and Bones; Child; Connective Tissue Diseases; Diphosphonates; Female; Fibula; Follow-Up Studies; Foot Injuries; Fractures, Bone; Hip Fractures; Humans; Leg Injuries; Male; Middle Aged; Radionuclide Imaging; Retrospective Studies; Sports; Technetium; Technetium Tc 99m Medronate; Tibial Fractures; Time Factors

Incomplete stress fractures of the proximal tibial diaphysis can be diagnosed by bone scintigraphy. The scintigraphic appearance of incomplete rather than complete tibial stress fractures is apparently reported for the first time in this article. With no treatment other than restricted activity, this injury heals rapidly and completely in 4 to 6 weeks. The major threat to the patient's welfare is unfounded suspicion of tumor or infection which may lead to biopsy or inappropriate therapy.

Topics: Adolescent; Adult; Athletic Injuries; Diphosphonates; Humans; Male; Physical Exertion; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Tibial Fractures

The clinical entity, "shin splints," is now being recognized, and more specifically characterized by the findings of exercise-induced pain and tenderness to palpation along the posterior medial border of the tibia. In this prospective study, ten patients with this syndrome were evaluated using three-phase bone scintigrams, and a specific scintigraphic pattern was determined. Radionuclide angiograms and blood-pool images were all normal. On delayed images, tibial lesions involved the posterior cortex, were longitudinally oriented, were long, involving one third of the length of the bone, and often showed varying tracer uptake along that length. Obtaining both lateral and medial views was crucial. The location of activity suggested that this entity is related to the soleus muscle. These scintigraphic findings can be used to differentiate shin splints from stress fractures or other conditions causing pain in the lower leg in athletes.

Topics: Adolescent; Adult; Athletic Injuries; Dancing; Diphosphonates; Female; Hockey; Humans; Leg Injuries; Male; Muscles; Prospective Studies; Radionuclide Imaging; Running; Technetium; Technetium Tc 99m Medronate; Tibia

We describe two unusual exercise-related stress fractures, one in the sacroiliac joint of a long distance runner, the other in the body of the scapulae of an above-knee amputee. Each were detected on a 2-hour delay bone scan. To our knowledge, neither have been described scintigraphically. The bilateral scapular fracture is an unreported entity, and the fractured SI joint is a very uncommon site for an overuse injury.

Topics: Adolescent; Athletic Injuries; Diphosphonates; Fractures, Bone; Humans; Male; Middle Aged; Radionuclide Imaging; Running; Sacroiliac Joint; Scapula; Sports; Technetium; Technetium Tc 99m Medronate; Weight Lifting

Very high muscle uptake of Tc-99m MDP was seen two days after the start of a program of vigorous weight-lifting exercises. Localization of Tc-99m bone tracer in muscle that has been damaged by exertion may be a more common phenomenon than is recognized at present.

Topics: Adult; Athletic Injuries; Diphosphonates; Humans; Male; Muscles; Radionuclide Imaging; Sports; Technetium; Technetium Tc 99m Medronate; Weight Lifting

Topics: Adolescent; Adult; Athletic Injuries; Bone and Bones; Child; Diphosphonates; Female; Fractures, Bone; Humans; Male; Middle Aged; Radionuclide Imaging; Stress, Mechanical; Technetium; Technetium Tc 99m Medronate

Topics: Adolescent; Adult; Athletic Injuries; Diphosphonates; Female; Fibula; Fractures, Bone; Humans; Male; Middle Aged; Radionuclide Imaging; Running; Stress, Mechanical; Technetium; Technetium Tc 99m Medronate; Tibial Fractures

Increased participation in sports by the general public has led to an increase in sports-induced injuries, including stress fractures, shin splints, arthritis, and a host of musculotendinous maladies. Bone scintigraphy with Tc-99m MDP has been used with increasing frequency in detecting stress fractures, but this study can miss certain important conditions and detect other lesions of lesser clinical significance. This paper demonstrates the spectrum of findings on bone scanning in nonacute sports trauma and offers suggestions for the optimal use of Tc-99m MDP for detecting the causes of lower extremity pain in athletes.

Topics: Adolescent; Adult; Arthritis; Athletic Injuries; Bone and Bones; Diphosphonates; Female; Fractures, Bone; Humans; Leg; Male; Muscles; Pain; Radionuclide Imaging; Sports Medicine; Technetium; Technetium Tc 99m Medronate

Tarsal navicular stress fractures are a potential source of disabling foot pain in physically active individuals. The diagnosis of tarsal navicular stress fracture requires a high index of clinical and radiographic suspicion because the fracture is only rarely evident on routine radiographs or standard tomograms. The radiographic diagnosis of a tarsal navicular stress fracture may require anatomic anteroposterior tomograms or a radionuclide bone scan with plantar views. Radiographic examinations of 23 fractures in 21 patients are evaluated.

Topics: Adult; Athletic Injuries; Diphosphonates; Female; Foot; Fractures, Bone; Humans; Male; Radionuclide Imaging; Tarsal Bones; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed