technetium-tc-99m-medronate and Hemarthrosis

Topics: Adult; Ankle Joint; Bone and Bones; Hemarthrosis; Hemophilia A; HIV Seropositivity; Humans; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

In 34 femoral neck fractures, CT was performed within 1-32 days after internal fixation. All the cases except one showed an increased distance between the femoral neck and the anterior aspect of the joint capsule as compared with the intact side, indicating varying degrees of hip joint effusion and/or synovitis. Hip joint aspiration in 11 patients revealed increased intracapsular pressure varying between 10 and 112 mmHg and volumes of aspirated joint effusion up to 23 ml. Pain relief and increased joint motion after drainage of the intracapsular effusion was observed in 3 patients whose postoperative mobilization was facilitated.

Topics: Aged; Exudates and Transudates; Female; Femoral Neck Fractures; Fracture Fixation, Internal; Hemarthrosis; Hip Joint; Humans; Male; Middle Aged; Postoperative Complications; Pressure; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

In eight undisplaced intracapsular fractures of the femoral neck, an intracapsular hematoma was diagnosed by computed tomography. 99mTc-MDP scintimetry revealed markedly reduced or absent blood supply to the head of femur. The intracapsular pressure was 23 (2.7-43) kPa with the hip in neutral position. Following aspiration of 12 (0.5-36) ml of blood, pressure was reduced to zero, and postaspiration scintimetry revealed restitution of blood supply to the femoral head. Hip joint tamponade in these patients has caused femoral head ischemia, reversible by aspiration.

Topics: Aged; Aged, 80 and over; Femoral Neck Fractures; Femur Head; Hemarthrosis; Hip Joint; Humans; Ischemia; Middle Aged; Pressure; Radionuclide Imaging; Suction; Technetium Tc 99m Medronate; Time Factors; Tomography, X-Ray Computed