technetium-tc-99m-medronate and Cartilage-Diseases

We studied the results of bone scans in 50 consecutive patients with symptomatic, unilateral, chronic anterior cruciate ligament (ACL) tears. All patients had failed conservative therapy and underwent radionuclide imaging of the knee prior to arthroscopic ACL reconstruction. The scintigraphic activity in each of the three knee compartments was quantitatively scaled from 1 (normal scintigraphic activity) to 4 (marked activity). Quantitative activity in each of the three compartments was correlated with plain radiographic, arthroscopic, and clinical findings. All but four of the scans (92%) showed abnormal scintigraphic activity. The quantitative activity was highest overall in the medial compartment (2.9), followed by the lateral (2.4) and patellofemoral compartments (1.9). In the subgroup of patients with normal menisci (10 patients), most of the abnormal activity was in the lateral compartment (2.9), implying that when the medial meniscus remains competent in the presence of a torn ACL, there is increased stress on the lateral compartment. There was little correlation with scintigraphy and roentgenographic changes, except in the presence of moderate or severe radiographic degenerative arthritis. Similarly, there was little correlation between increased scintigraphic activity and chondromalacia. These results provide a baseline for future studies that use scintigraphic imaging in monitoring restoration of bone homeostasis following ACL reconstruction.

Topics: Adolescent; Adult; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Arthroscopy; Cartilage Diseases; Chronic Disease; Evaluation Studies as Topic; Female; Humans; Injury Severity Score; Male; Osteoarthritis; Preoperative Care; Radiography; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate; Wounds and Injuries

Premature closure of the physis of the greater trochanter has been reported to be a predictive sign of chondrolysis in hips with slipped capital femoral epiphysis (SCFE). In the present series, the physis of the greater trochanter showed decreased activity on bone scintigraphy in 16 patients with SCFE and concurrent or developing chondrolysis. In five of these patients, the scintigraphic pattern (decreased activity of the physis of the greater trochanter) preceded radiographic changes of chondrolysis. In 13 patients with SCFE without chondrolysis, the physis of the greater trochanter appeared normal on scintigrams and open on radiographs. Use of scintigraphy in patients with SCFE permitted earlier recognition of chondrolysis, increasing the potential of altering the course of the disease.

Topics: Adolescent; Cartilage Diseases; Child; Epiphyses, Slipped; Female; Hip Joint; Humans; Male; Pelvic Bones; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Young patients with symptoms of anterior knee discomfort represent a most difficult and often enigmatic clinical group, in large part because of the highly subjective nature of the condition. A primary clinical research goal over the past several years has been a search for reliable objective indicators of a presumed underlying pathologic process to account for the symptoms. We believe that the use of the bone scan along with other clinical and experimental data has provided a new and previously unappreciated perspective of a dynamic osseous process occurring in many such patients. With further investigation, this process may clarify certain confusing aspects of the symptoms experienced by patients with patellofemoral pain. The technique and its clinical applications are still in its infancy, yet it appears to hold promise for the future. It is hoped that exposure to this method of evaluation will serve as a basis for an understanding of the benefits, limitations, and implications of this technique as further developments occur.

Topics: Adolescent; Adult; Arthroscopy; Cartilage Diseases; Computers; Female; Femur; Homeostasis; Humans; Knee Injuries; Knee Joint; Male; Middle Aged; Models, Biological; Osteoclasts; Pain; Patella; Prostaglandins E; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Technetium Tc 99m Medronate

Scintigraphy with Technetium methylene diphosphate gives a positive result in bone tissue in a state of raised metabolic activity. This can be used in the diagnosis of mechanical stress lesions in bone. The authors present several clinical examples confirming the usefulness of this method.

Topics: Adult; Aged; Bone Diseases; Cartilage Diseases; Female; Femur Head Necrosis; Hip Joint; Hip Prosthesis; Humans; Joint Diseases; Knee Joint; Male; Middle Aged; Radionuclide Imaging; Stress, Physiological; Technetium Tc 99m Medronate

Topics: Adolescent; Adult; Age Factors; Aged; Cartilage Diseases; Cartilage, Articular; Child; Child, Preschool; Diphosphonates; Female; Humans; Knee Joint; Male; Middle Aged; Osteoarthritis; Patella; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate