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

To evaluate the role of 99m-technetium methylene diphosphonate (Tc-99m MDP) bone scintigraphy on the detection of joint damage in asymptomatic alpine ski racers.. This study included 20 male asymptomatic alpine ski racers (age range: 18-21 years). None of the skiers had a history of ski crashes. Bone scan findings of the racers were examined with Tc-99m MDP bone scintigraphy during the active racing season and the inactive training season. Planar anterior and posterior images of hip, knee, and ankle joints were obtained 4 h after intravenous injection of 20 mCi Tc-99m MDP. All images were interpreted visually by 2 experienced nuclear medicine physicians. Free regions of interest were drawn on hip, knee, and ankle joints, as well as background regions. Joint-to-background ratios were calculated for each joint, and the uptake ratios of both right and left joints during active ski season were compared to those during the inactive training period.. Uptake ratios of the right and left hip, knee, and ankle joints were significantly higher during the active racing period than those calculated during the inactive period (P < 0.005).. Bone scintigraphy may have an important role in detecting joint injuries of hip, knee, and ankle joints in asymptomatic alpine ski racers and can be used successfully when MRI is unavailable.

Topics: Adolescent; Adult; Ankle Injuries; Asymptomatic Diseases; Hip Injuries; Humans; Knee Injuries; Lower Extremity; Male; Radionuclide Imaging; Radiopharmaceuticals; Skiing; Technetium Tc 99m Medronate; Young Adult

Acetabular labral tears are an increasingly recognized cause of hip pain in young adults with hip dysplasia and older patients with degenerative disease of the hips.. The authors analyzed retrospectively bone scintigraphy in 27 patients with acetabular labral tears diagnosed by MRI/arthroscopy. Analysis was also made of scintigraphy in 30 patients without labral tears being investigated for other causes of hip pain for comparison.. Patients with labral tears had hyperemia of the superior or superomedial aspect of the acetabulum and increased delayed uptake in either a focal superior pattern or in an "eyebrow" pattern of a superomedial tear. This pattern was not seen in any other sources of hip pathology.. Uptake in the superior or superomedial aspect of the acetabular rim is characteristic of a labral tear. Absence of this pattern carries a high negative predictive value for the diagnosis.

Topics: Acetabulum; Adult; Aged; Arthroscopy; Cartilage, Articular; Hip Injuries; Humans; Magnetic Resonance Imaging; Middle Aged; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate

Two elderly patients had pain after hip trauma with no radiographic evidence of fracture. Computed tomography demonstrated capsular haematoma. Scintimetry revealed femoral head ischaemia. Intracapsular hip joint pressure in extension was 240 and 176 mm Hg, respectively, in neutral position and 280 and 360 mm Hg in internal rotation. The hip joints were aspirated for 8 ml and 5 ml of blood, respectively, leading to pain relief and regained radiotracer uptake in the femoral head. It is concluded that traumatic hip joint tamponade may cause femoral head ischaemia which may be reversed by aspiration.

Topics: Accidents, Home; Aged; Diphosphonates; Female; Femur Head; Hip Injuries; Hip Joint; Humans; Ischemia; Male; Pressure; Radionuclide Imaging; Suction; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed