technetium-tc-99m-medronate and Chronic-Kidney-Disease-Mineral-and-Bone-Disorder

The histologic features of renal osteodystrophy vary from dialysis osteomalacia to osteitis fibrosa cystica. Commensurate with this, the number of osteoblasts and osteoclasts changes with the stage of the disease; the osteoblasts are virtually absent in dialysis osteomalacia and are numerous in osteitis fibrosa. Radiophosphate accretion in bone increases with increasing osteoblastic activity, and the bone mineral status is determined by the net difference in osteoblastic and osteoclastic activity. The application of radionuclide imaging and dual radiographic absorptiometry mineral measurements in patients with renal osteodystrophy, renal transplants, and following parathyroidectomy for secondary hyperparathyroidism is reviewed.

Topics: Bone Density; Chronic Kidney Disease-Mineral and Bone Disorder; Densitometry; Humans; Parathyroid Glands; Parathyroidectomy; Radionuclide Imaging; Technetium Tc 99m Medronate

In patients with renal bone disease skeletal and extra-skeletal abnormalities can be visualised using conventional bone scintigraphy. Some of these abnormalities are associated with characteristic scintigraphic appearances, which are reviewed in detail, and the possible mechanisms involved are discussed. Specific imaging with iodine 123 serum amyloid P component and iodine 131 beta 2-microglobulin is also discussed in the diagnosis of beta 2-microglobulin amyloidosis specific to patients on dialysis. In the light of available evidence, it appears that bone scintigraphy plays, so far, a limited role in the clinical evaluation of skeletal and extra-skeletal abnormalities in chronic renal failure. The potential role of bone scintigraphy in identifying patients with aluminium-related bone disease needs to be investigated further, and in this respect special attention must be given to the problem of high soft-tissue activity associated with impaired renal function. Timing haemodialysis sessions before scintigraphic imaging deserves wider recognition as it reduces high soft-tissue activity, thereby allowing bone uptake to be assessed more accurately. Specific imaging of amyloidosis resulting from beta 2-microglobulin deposition is a promising technique, but the relative value of the two proposed radiopharmaceuticals needs further clarification.

Topics: Amyloidosis; Calcinosis; Chronic Kidney Disease-Mineral and Bone Disorder; Etidronic Acid; Humans; Kidney Failure, Chronic; Organotechnetium Compounds; Radionuclide Imaging; Renal Dialysis; Technetium Tc 99m Medronate

Topics: Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Humans; Radionuclide Imaging; Technetium Tc 99m Medronate

Radionuclide imaging with Tc-99m diphosphonates is not an effective method for detecting or ruling out most osteoporotic diseases including senile osteoporosis or accelerated postmenopausal osteoporosis, and the slow loss of bone tissue generally remains undetected by this modality. Nonetheless, it frequently surpasses or supplements radiographic findings in evaluating the focal complications of metabolic bone disease, including fractures, microfractures, stress fractures, vertebral compressions, Milkman-Looser zones, aseptic necrosis, and acute infarction. In contrast to its secondary role in osteoporosis, bone imaging is of prime importance in investigating hypercalcemia, because the major cause of this abnormality is skeletal metastatic malignancy. In defective bone mineralization due to hyperparathyroidism or osteomalacia, a general increase in diphosphonate skeletal uptake is detected more frequently than radiographic abnormalities. However, normal skeletal images do not rule out metabolic bone disease. Biochemical testing is more reliable in detecting primary hyperparathyroidism. On the other hand, in renal osteodystrophy, biochemical abnormalities are variable and bone imaging is helpful in assessing the severity of skeletal involvement, but not its etiology. Many methods of quantitating the kinetics of Tc-99m diphosphonates have been explored, such as plasma clearance, bone-to-soft-tissue ratios, 24-hour total body retention and 24-hour urinary excretion. None of these have been widely accepted. The value of bone imaging is established in other systemic diseases, most notably in Paget's disease, hypertrophic pulmonary osteoarthropathy, sickle cell disease, fibrous dysplasia, and sympathetic dystrophy.

Topics: Bone Diseases; Bone Diseases, Metabolic; Chronic Kidney Disease-Mineral and Bone Disorder; Humans; Hypercalcemia; Osteoporosis; Radionuclide Imaging; Technetium Tc 99m Medronate

It is important to estimate the bone metabolism in patients with renal osteodystrophy. The methods of estimation must be noninvasive, accurate, and able to measure repeatedly.. The regions of interest on bone scintigraphy were drawn over the radius in 22 hemodialysis patients (10 males, 12 females). The bone/soft tissue ratio (B/ST ratio) was calculated for all patients. The bone soft tissue ratio of both skull (S) and radius (R) was obtained from the resultant count ratios. We investigated the correlation between intact parathyroid hormone (PTH), alkaline phosphatase (ALP) and the uptake ratios S and R.. Intact PTH had a significantly linear correlation with R (r = 0.745, p < 0.0001) and S (r = 0.702, p = 0.0001). ALP also had a significantly linear correlation with R (r = 0.537, p = 0.009) and S (r = 0.772, p < 0.0001).. The measurement of the bone soft tissue ratio of radius on bone scintigraphy was crucial for estimating renal osteodystrophy.

Topics: Adult; Aged; Alkaline Phosphatase; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Male; Middle Aged; Parathyroid Hormone; Prognosis; Radionuclide Imaging; Radiopharmaceuticals; Radius; Renal Dialysis; Reproducibility of Results; Sensitivity and Specificity; Skull; Technetium Tc 99m Medronate

Intact parathyroid hormone (PTH) assay has recently been reported to be effective in evaluating both 1-84 PTH (whole PTH) and inactive 7-84 PTH. Inactive 7-84 PTH is considered to be increased in hemodialysis patients and to prevent the effects of 1-84 PTH, and intact PTH is considered to overestimate the PTH activity in these patients. As such, a whole PTH assay has recently been developed. The purpose of this study was to examine the usefulness of a whole PTH assay using the bone to soft tissue (B/ST) ratio on bone scintigraphy.. Twenty-five hemodialysis patients were included in our study. In all patients, bone scintigraphy and a blood test [whole PTH, intact PTH, alkaline phosphatase (ALP), calcium (Ca), and phosphorus (P)] were performed. Regions of interest (ROIs) were drawn around the cranium, lumbar vertebrae, left femoral neck, and soft tissue of the medial left thigh to obtain the B/ST ratio.. The B/ST ratio of the cranium and left femoral neck correlated with whole PTH and intact PTH. In particular, the B/ST ratio of the cranium correlated most significantly with the value of whole PTH. Whole PTH levels correlated with intact PTH levels (r = 0.891, p < 0.0001).. Our data indicate that a whole PTH assay may be useful in evaluating PTH activity using the B/ST ratio. The B/ST ratio of the cranium may reflect the bone metabolism of hemodialysis patients.

Topics: Adult; Aged; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Male; Middle Aged; Parathyroid Hormone; Prognosis; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Technetium Tc 99m Medronate

Renal osteodystrophy is a metabolic bone disease and a common complication of end-stage chronic renal failure and maintenance dialysis treatment. In this study, we examined the correlation between quantifying bone scintigraphy and serum biochemical markers in hemodialysis patients.. Bone scintigraphy with technetium-99m-hydroxy-methylene-diphosphonate (99mTc-HMDP) was performed on 28 patients on maintenance hemodialysis. Bone scintigraphy was performed using a standard protocol and was quantified by setting regions of interest (ROIs) over selected regions. The bone-to-soft-tissue ratio (B/ST ratio) at each region was calculated in all patients. The B/ST ratios were then compared with serum biochemical markers.. The B/ST ratio for the skull correlated well with serum bone-specific alkaline phosphatase (BAP) (r = 0.735, p < 0.001), serum deoxypyridinoline (DPD) (r = 0.806, p < 0.001) and intact parathyroid hormone (intact PTH) (r = 0.701, p < 0.001). The B/ST ratio for the lumbar spine correlated with intact PTH (r = 0.387, p < 0.05) but not with serum BAP or serum DPD. The B/ST ratio for the femoral neck correlated with serum DPD (r = 0.431, p < 0.05) and intact PTH (r = 0.449, p < 0.05) but not with serum BAP.. Our data suggest that quantitative bone scintigraphy is a sensitive and useful method for evaluating bone metabolism in hemodialysis patients. The B/ST ratio for the skull may reflect changes of bone metabolism in hemodialysis patients.

Topics: Adult; Aged; Alkaline Phosphatase; Amino Acids; Biomarkers; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Parathyroid Hormone; Radionuclide Imaging; Radiopharmaceuticals; Renal Dialysis; Reproducibility of Results; Sensitivity and Specificity; Statistics as Topic; Technetium Tc 99m Medronate

Pentavalent 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy and 99mTc-hydroxymethylene diphosphonate (HMDP) bone scan were performed in one patient with renal osteodystrophy (ROD) before and after vitamin D3 pulse therapy. The bone scan showed diffusely increased tracer uptake in the whole skeleton, and no change of tracer distribution was noted before or after vitamin D3 pulse therapy. However, 99mTc(V)-DMSA scintigraphy revealed diffusely increased tracer uptake in the whole skeleton before therapy, and markedly decreased tracer uptake in the bones was seen at 5 mo after therapy. Increased uptake of 99mTc(V)-DMSA was observed at 7 mo after therapy, which reflected the laboratory findings. Technetium-99m-(V)-DMSA scintigraphy appeared to be more sensitive than the conventional 99mTc-HMDP bone scan in assessing the characteristics and therapeutic effect of bone disease in ROD.

Topics: Adult; Bone and Bones; Calcitriol; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate

The efficiency and accuracy of a functional imaging technique in the detection of ischemic osteopathy is reviewed over a 10-year period. The study includes 161 patients who had trauma, 101 patients who had suspected Perthes disease, 43 patients who had dysbarism, and 22 patients who had renal transplants on steroid immunosuppressive therapy. After intravenous injection of 7.7 MBq kg-1 Tc-99m HDP data were collected on all patients during the first 20 minutes, accretion rate functional images were produced, and static bone scans performed after 3 hours. All patients were followed up until a definitive diagnosis (clinical and radiologic) of avascular necrosis or osteochondritis was confirmed or denied. Of the 327 patients studied, 114 had positive accretion rate images and 213 negative accretion rate images. There were 8 false-positive scan results and 2 false-negative scan results. The overall predictive accuracy was 97% (disease prevalence 33%) with a sensitivity rate of 98% and a specificity rate of 96%. The authors conclude that the technique is a valuable predictive diagnostic indicator for ischemic osteopathies.

Topics: Barotrauma; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Femur Head Necrosis; Fractures, Ununited; Humans; Kidney Transplantation; Legg-Calve-Perthes Disease; Osteochondritis; Predictive Value of Tests; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate

To determine whether quantitative bone scintigraphy (QBS) with single-energy photon emission computed tomography (SPECT) can help predict which patients with chronic renal disease will show bone mineral density (BMD) loss.. In 18 patients, the percentage of injected dose of technetium-99m methylene diphosphonate per cubic centimeter of bone was measured with QBS SPECT in the lumbar vertebrae and femoral neck. The differences in BMD over an average of 20 months were measured and compared with SPECT measurements. QBS values were also compared with serum bone turnover markers.. There was a negative correlation (r = -.54, P < .05 for the lumbar spine and r = -.60, P < .01 for the femoral neck) between QBS values and bone loss. Positive and negative predictive values, sensitivity, and specificity of QBS for bone loss in the lumbar spine were 78%, 71%, 78%, and 71%, respectively, and in the femoral neck, 82%, 100%, 100%, and 78%, respectively. Differences between predictive values of serum bone turnover markers were not statistically significant.. QBS with SPECT enabled prediction of rapid bone loss in patients with renal disease.

Topics: Absorptiometry, Photon; Aged; Alkaline Phosphatase; Biomarkers; Bone Density; Calcium; Chronic Disease; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Femur Neck; Follow-Up Studies; Forecasting; Humans; Kidney Failure, Chronic; Lumbar Vertebrae; Male; Middle Aged; Osteocalcin; Parathyroid Hormone; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Topics: Adult; Bone and Bones; Calcinosis; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Radionuclide Imaging; Renal Dialysis; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adult; Aged; Aged, 80 and over; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Hyperparathyroidism, Secondary; Osteomalacia; Radionuclide Imaging; Technetium Tc 99m Medronate

We have used 99Tcm-MDP to develop a measure of overall skeletal activity for use in renal disease. The method utilizes the relative clearances of 99Tcm-MDP and 51Cr-EDTA from the blood after simultaneous injection. This is expressed as a ratio and the upper limit in normals is 1.4. This ratio has been evaluated in 42 patients with chronic renal failure and compared with appearances of left-hand radiographs. The ratio was elevated in these patients and the level corresponded to the degree of severity of the subperiosteal resorption. Similarly, there was a close correlation between the ratio values and the serum alkaline phosphatase measurements and parathyroid hormone values. Thirty-three patients had sequential studies performed at intervals of up to 2 years. Twenty-one patients showed no change on clinical, biochemical or bone scan evaluation. Of these, only one patient showed a change in ratio value of greater than 20%. Twelve patients showed evidence of change based either on clinical, biochemical or bone scan alteration and all 12 patients showed changes in ratio values greater than 20%. The 51Cr-EDTA/99Tcm-MDP ratio appears to offer not only a single plasma sample method for the detection and evaluation of renal bone disease, but our results also suggest that it may be valuable in the follow-up of these patients.

Topics: Chromium Radioisotopes; Chronic Kidney Disease-Mineral and Bone Disorder; Edetic Acid; Humans; Metabolic Clearance Rate; Technetium Tc 99m Medronate

Bone scintigraphy before and after renal transplantation was studied in 14 patients with renal osteodystrophy. The radionuclide distribution patterns visualized on the images before transplantation were classified into two groups; one group with markedly increased tracer uptake throughout the whole skeleton, especially in the skull, another group with prominent tracer uptake in the soft tissues. These abnormal tracer accumulations improved after renal transplantation. Bone scintigraphy before and after renal transplantation provides useful information concerning the follow-up of patients with renal osteodystrophy.

Topics: Adult; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Kidney Transplantation; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adult; Alkaline Phosphatase; Bone and Bones; Calcium; Chronic Kidney Disease-Mineral and Bone Disorder; Creatinine; Female; Humans; Kidney Transplantation; Male; Parathyroid Hormone; Phosphorus; Radionuclide Imaging; Reference Values; Technetium Tc 99m Medronate

During osteomalacia in patients with terminal renal failure, the coefficient of diphosphonate elimination from the blood bed (K1) was less than 0.1 min-1, which was determined by the rise of the concentration of uremic toxins, inhibiting interaction of the radiopharmaceutical with the bone, in the patients' tissues. Dynamic scintigraphy permits one to study the pharmacokinetics of diphosphonate in every patient and thus can be used for differential diagnosis between osteomalacia and other forms of renal osteodystrophy.

Topics: Chronic Kidney Disease-Mineral and Bone Disorder; Diagnosis, Differential; Humans; Kidney Failure, Chronic; Osteomalacia; Radionuclide Imaging; Technetium Tc 99m Medronate

Remarkably high accumulation of Tc-99m-MDP is seen in the skull on bone scintigraphy of patients with renal osteodystrophy (ROD), especially with secondary hyperparathyroidism. For the quantitative evaluation, the Factor Analysis (FA) was used for the early phase of bone scan. Tc-99m-MDP (14.8 MBq/body weight kg) was injected as a bolus through the medial antecubital vein. Dynamic acquisition of 40 x 30 sec frames were performed in a 64 x 64 matrix. For pre-processing, nine points smoothing was carried out, and then the region of interest was set on the frontal image of the head for the FA. The FA was performed with an 8 x 8 sampling corresponding to 64 dixels from 4,096 dixels. Bone factor was clearly extracted by the FA. Then, two original parameters were calculated. One is the bone radionuclide uptake counts (Bu) which is the product of the total radionuclide counts of skull and the contribution ratio, the other is the uptake ratio (Br) derived by the time activity curve (physiological component) of the FA. These parameters of ROD were significantly different compared to those of controls. The FA seems to be useful in quantitative evaluation of bone mineral dynamics.

Topics: Adult; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Male; Middle Aged; Minerals; Radionuclide Imaging; Technetium Tc 99m Medronate

Four color processed whole body bone scintigraphy with 99mTc-methylene diphosphonate was performed in six patients on maintenance hemodialysis, and the results of semiquantitative colorimetric analysis were compared with those of a normal group. The difference between the two (control and patient group) was statistically significant (P less than 0.01). Furthermore, the effect of 1 alpha-hydroxyvitamin D3 treatment on renal osteodystrophy was evaluated by this method. The results indicated that this method provides a useful method for assessing the response of renal osteodystrophy to treatment. Two representative cases of renal osteodystrophy are presented to illustrate the usefulness of this approach to semiquantitative whole body bone scanning.

Topics: Adult; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Hydroxycholecalciferols; Male; Middle Aged; Radionuclide Imaging; Renal Dialysis; Subtraction Technique; Technetium; Technetium Tc 99m Medronate; Whole-Body Counting

Topics: Chromium Radioisotopes; Chronic Kidney Disease-Mineral and Bone Disorder; Edetic Acid; Humans; Radionuclide Imaging; Technetium Tc 99m Medronate

A case of false-negative Tc-99m MDP bone scintigrams, taken at one and two weeks for pathologic fractures in a patient with metabolic bone disease and a super-scan appearance, is described. The patient had renal osteodystrophy, and postparathyroidectomy hypocalcemia. Postoperative seizures caused multiple pathologic fractures. Initial scans were negative for focal tracer localization in the presence of a continued super-scan appearance. After months of calcium and vitamin D replacement therapy, fracture sites became positive on Tc-99m MDP imaging. The observations in this case lend credence to the hypothesis of Tc-99m MDP binding by immature collagen in the production of a super scan in metabolic bone disease, as well as that of Tc-99m MDP chemisorption to calcium hydroxyapatite crystal in fracture healing. In addition, aluminum toxicity, common in chronic renal osteodystrophy, may have played a role in the delayed fracture healing.

Topics: Adult; Chronic Kidney Disease-Mineral and Bone Disorder; Diagnostic Errors; Fractures, Spontaneous; Humans; Hypocalcemia; Male; Parathyroid Glands; Postoperative Complications; Radionuclide Imaging; Seizures; Technetium Tc 99m Medronate

Topics: Adult; Chronic Kidney Disease-Mineral and Bone Disorder; Humans; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

The value of radionuclide bone scanning in the diagnosis of renal osteodystrophy is still debated. In order to re-examine this issue, 25 uremic patients treated by intermittent hemodialysis underwent 99m-Technetium Methylene Diphosphonate (99mTc-MDP) bone scan. They were subdivided into three groups according to quantitative bone histology. Group 1 (N = 8) had pure dialysis osteomalacia, group 2 (N = 7) mixed lesions, and group 3 (N = 10) pure osteitis fibrosa. The scintigraphic studies were interpreted by means of a five point semi-quantitative scale. Using this quantification, all but one group 1 patients had decreased bone tracer uptake, and all patients of group 3 had an increased uptake (chi square test of Yates, P less than 0.001). Among patients of group 2, bone uptake was decreased in the three patients with clearly reduced mineralization front and moderate osteitis fibrosa, but it was increased in all patients with severe osteitis fibrosa and subnormal mineralization front. A quantitative analysis of regional tracer uptake into bone was performed in two patients: one of group 2 and one of group 3. The results obtained clearly corroborated the semi-quantitative findings. Thus, in hemodialysis patients with symptomatic bone disease, the 99mTc-MDP bone scan provides useful information for the differential diagnosis between dialysis-related osteomalacia and secondary hyperparathyroidism. In patients with mixed lesions, the importance of bone tracer uptake appears to depend on the extent of the mineralization front and on the intensity of osteitis fibrosa.

Topics: Adult; Aged; Biopsy; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Male; Middle Aged; Osteitis Fibrosa Cystica; Osteomalacia; Radionuclide Imaging; Renal Dialysis; Technetium Tc 99m Medronate; Uremia

Renal osteodystrophy, a frequent complication of chronic renal failure, can be recognized and the diagnosis suggested with a fairly high degree of confidence on bone imaging, if one is familiar with common scintigraphic findings. This case report illustrates some of those findings.

Topics: Aged; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Humans; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

Subperiosteal bone formation, in contradistinction to resorption, is an unusual occurrence in renal osteodystrophy, and particularly rare in the long bones of the lower extremities according to the radiological literature. Two cases are presented with radiographic and radiophosphate evidence of subperiosteal bone formation in the femora and tibiae, and both showed histologic changes of profound secondary hyperparathyroidism.

Topics: Aged; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Middle Aged; Osteogenesis; Periosteum; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adolescent; Adult; Aged; Bone and Bones; Child; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphonates; Female; Humans; Hyperparathyroidism, Secondary; Male; Middle Aged; Osteomalacia; Radionuclide Imaging; Renal Dialysis; Technetium; Technetium Tc 99m Medronate

A method is described for the quantitation of total skeletal activity during bone scans. The method requires a single plasma sample only, taken at the time of imaging. The ratio of % injected dose of 51Cr EDTA to that of 99Tcm MDP is calculated from this sample following combined injection of the two radiopharmaceuticals. The 51Cr EDTA level corrects for the glomerular filtration of 99Tcm MDP. Using this method, which only requires a gamma counter, significant differences from normal controls have been shown in patients with osteomalacia, renal osteodystrophy, Paget's disease and hypercalcaemia. The method provides routine quantitative data to add to the imaging information in the bone scan.

Topics: Adult; Aged; Bone and Bones; Bone Diseases, Metabolic; Chromium Radioisotopes; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphonates; Edetic Acid; Humans; Hypercalcemia; Metabolic Clearance Rate; Middle Aged; Osteitis Deformans; Osteomalacia; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

The clinical applicability of bone scintigraphy (Tc99m MDP) was evaluated in 42 patients on maintenance hemodialysis. Typical scintigraphic findings are shown which were related to hormonal and biochemical parameters of calcium and phosphate metabolism. Visual grading of representative regions for metabolic bone disease in bone scans was compared to scintimetry which applies a bone to soft tissue ratio to grade osseous abnormalities. It could be shown that visual interpretation and grading of the findings according to a score is sufficient to assess the degree and extent of renal bone disease. Semiquantitative analysis of bone scintigrams by scintimetry did not improve the diagnostic information.

Topics: Adult; Aged; Alkaline Phosphatase; Bone and Bones; Calcium; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphonates; Female; Hand; Humans; Male; Mandible; Middle Aged; Parathyroid Hormone; Radionuclide Imaging; Renal Dialysis; Technetium; Technetium Tc 99m Medronate

The distribution of 99mTc-Sn-MDP in the thigh was estimated according to two different indices in 60 normal patients, 21 patients undergoing haemodialysis and one who had had a renal transplant. Deviation of the indices in these patients from the normal are significant. The indices were correlated with respect to their accuracy in detecting renal osteopathy with histomorphometry (as the reference method), radiological diagnosis, densitometry, parathormone assay and other laboratory tests. Accuracy of the method is high and, like histomorphometry, is over 90%.

Topics: Absorptiometry, Photon; Adult; Aged; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphonates; Femur; Humans; Ilium; Kidney Transplantation; Middle Aged; Parathyroid Hormone; Radionuclide Imaging; Renal Dialysis; Technetium; Technetium Tc 99m Medronate

The bone scan may be of value in the assessment of patients with metabolic bone disease. However the superiority of the bone scan when compared to radiology in conditions such as renal osteodystrophy, osteomalacia, primary hyperparathyroidism, and osteoporosis requires substantiation with the newer radiopharmaceuticals which have a higher affinity for bone. Two methods of quantitating skeletal uptake of tracer have been assessed to try to remove the subjective aspect of bone scan evaluation. Measurements of bone to soft tissue ratios have proved clinically disappointing, but 24 hour whole body retention of diphosphonate appears to provide a sensitive index of increased bone turnover.

Topics: Bone and Bones; Bone Diseases, Metabolic; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphonates; Etidronic Acid; Humans; Hyperthyroidism; Organotechnetium Compounds; Osteomalacia; Osteoporosis; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Bone and Bones; Calcinosis; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphonates; Female; Humans; Male; Radionuclide Imaging; Renal Dialysis; Technetium; Technetium Tc 99m Medronate

Topics: Adult; Aged; Biopsy; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphonates; Female; Humans; Male; Middle Aged; Technetium; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Uremia

Topics: Adolescent; Adult; Bone and Bones; Chronic Disease; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphonates; Female; Humans; Male; Middle Aged; Polyphosphates; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Uremia