technetium-tc-99m-medronate and Hyperemia

Plantar fasciitis is a common cause of foot pain and may be disabling. Although localized injection is painful, anesthetics or corticosteroids can relieve symptoms well. Bone scintigraphy can confirm the diagnosis. We hypothesized that blood-pool abnormalities could provide prognostic information on the response to such injections.. We devised scintigraphic criteria that graded the blood-pool abnormalities as being localized to the plantar enthesis, being localized to half the length of the aponeurosis, or involving the whole aponeurosis. We evaluated 24 patients with an established diagnosis of plantar fasciitis, 8 of whom had bilateral disease, leading to a total of 32 feet injected.. After injection, pain was relieved either completely or nearly completely in 20 feet. The other 12 feet had short-term or no improvement, with persistent pain and loss of function at 4-5 wk after injection. Of the 20 feet responding to injection, 14 had focal hyperemia on blood-pool images and 6 had minimal extension into the proximal third of the plantar soft tissues. No patient with diffuse hyperemia in the plantar fascia had a response (5/12 feet). On the delayed images of the 20 responders, mild inferior calcaneal uptake was seen in 8 feet, moderate uptake in 6, and severe uptake in 6. These groups did not significantly differ (P > 0.05). The blood-pool studies had good reproducibility, with a kappa-value of 0.64.. Critical evaluation of plantar blood-pool images provides prognostic information on the response to localized injection into the enthesis. Reporting such studies is simple and reproducible.

Topics: Adult; Anesthetics, Local; Anti-Inflammatory Agents; Bone and Bones; Bupivacaine; Cadaver; Drug Therapy, Combination; Fasciitis, Plantar; Female; Foot; Humans; Hyperemia; Injections; Male; Methylprednisolone; Middle Aged; Pain; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Treatment Outcome

Topics: Aged; Cutaneous Fistula; Female; Foot Bones; Foot Diseases; Humans; Hyperemia; Mycetoma; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Administration, Cutaneous; Aged; Female; Humans; Hyperemia; Nitroglycerin; Radionuclide Imaging; Ribs; Skin; Technetium Tc 99m Medronate

Tc-99m MDP three-phase bone imaging demonstrated the acute hyperemic inflammatory soft tissue phase of radiation injury to the hand in a patient receiving radiation therapy to bone lesions of multiple myeloma.

Topics: Acute Disease; Adult; Hand; Humans; Hyperemia; Inflammation; Male; Radionuclide Imaging; Radiotherapy; Technetium Tc 99m Medronate

The presence of transient soft-tissue activity in the left side and the lower midportion of the abdomen on the early phases of the multiphase bone scan represents postprandial physiologic hyperemia of the small intestine. The bowel uptake was present in all 33 patients ingesting food between 15 min and 3.5 hr before scanning. In those patients who had not eaten within 4 hr of the study, only 25% demonstrated bowel activity. The observation of bowel uptake is important in differentiating a physiologic phenomenon from pathologic accumulations of activity. Pathology should be ruled out when bowel activity is not located in the usual left flank and lower mid-abdomen, or is present in a fasting individual.

Topics: Adolescent; Adult; Bone and Bones; Child; Child, Preschool; Digestion; Female; Food; Humans; Hyperemia; Intestine, Small; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

Two patients with Freiberg's infraction of the second metatarsal are presented. The scintigraphic pattern of a photopenic defect with hyperactive collar is demonstrated as evidence of the existence of avascular necrosis or infarction in this entity. The photopenia was appreciated only on pinhole collimator images in our first patient. The later revascularization phase of avascular necrosis with diffuse increase in uptake is demonstrated scintigraphically in the second patient.

Topics: Adolescent; Child; Female; Foot Diseases; Humans; Hyperemia; Metatarsus; Osteochondritis; Osteonecrosis; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Bone and gallium scintigraphy were performed as part of the diagnostic workup of a 21-yr-old woman who presented at our institution with a history of progressively worsening low back pain over a 1-wk period of time. The angiographic phase of the bone scan demonstrated a well-defined radionuclide blush within the pelvis just cephalad to the urinary bladder with persistent hyperemia noted in the blood-pool image. We attribute these findings to a uterine blush secondary to the pronounced uterine muscular hyperplasia, hyperemia, and edema that accompany pregnancy. Gallium scintigraphy demonstrated intense bilateral breast accumulation of the imaging agent in a typical doughnut pattern which is commonly found in the prelactating and lactating breast. Also demonstrated was apparent gallium accumulation in the placenta. This case is presented to emphasize the radionuclide findings that occur during pregnancy, particularly the incidental finding of radionuclide blush during the angiographic phase of a radionuclide scintigraphy which should alert the nuclear physician to the possibility of pregnancy in a woman of childbearing age.

Topics: Adult; Back Pain; Bone and Bones; Breast; Female; Fetus; Fever of Unknown Origin; Gallium Radioisotopes; Humans; Hyperemia; Placenta; Pregnancy; Pregnancy Trimester, Second; Radiation Dosage; Radionuclide Imaging; Technetium Tc 99m Medronate; Uterus

Eighty-five patients with cerebral vascular accidents were assessed with three-phase bone scintigraphy of the hands and with whole-body delayed bone imaging. Nine patients (10%) had normal three-phase bone images. Fifty-five patients (65%) showed decreased blood flow and blood-pool images of the hands and wrists with normal delayed bone scintigrams, indicating the effect of paralysis or disuse. Twenty-one patients (25%) had diffuse increased uptake with periarticular accentuation, felt to be bone-scintigraphic evidence of reflex sympathetic dystrophy of the hands and wrists; in two patients this occurred before its clinical appearance. Thirteen of the 21 reflex sympathetic dystrophy syndromes (RDS)-involved limbs (62%) had increased blood flow, whereas 8 (38%) had decreased flow. Gross limb blood flow appears to be related to the degree of muscle activity, but flow may be altered by the presence of sympathetic changes. A possible dissociation between whole-limb flow and bone blood flow in paralyzed limbs involved with RDS is discussed. The elbow was involved in only one case, and a true "shoulder-hand" distribution was seen in only 11 of 21 cases (52%). Five patients (6%) had leg involvement on whole-body imaging. Traumatic synovitis of the wrist, and trauma to subluxed shoulders, could be recognized on the delayed study.

Topics: Adult; Aged; Arm; Bone and Bones; Cerebrovascular Disorders; Female; Hand; Hemiplegia; Humans; Hyperemia; Male; Middle Aged; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Regional Blood Flow; Shoulder; Technetium Tc 99m Medronate; Time Factors

Twenty-four symptomatic patients with symptoms of active Paget's disease of bone were evaluated, during the course of their therapy, a total of 71 times (24 baseline and 47 follow-up examinations) by serial alkaline phosphatase levels (AP), Tc-99m MDP bone scans, and radionuclide blood-flow studies. The flow study correlated with disease activity in all of the baseline studies and in at least 85% of the follow-up studies. In five patients (seven follow-up studies) the changes in local blood flow correctly anticipated the eventual rise or fall of AP. In comparison with the bone scan, the changes in blood flow preceded the bone-scan alterations or were more reliable indicators of disease activity in 12 of the 13 follow-up studies in which the results of the two examinations disagreed. We conclude that the radionuclide flow study provides useful additional clinical information in the management of Paget's disease.

Topics: Alkaline Phosphatase; Bone and Bones; Calcitonin; Diphosphonates; Drug Therapy, Combination; Etidronic Acid; Follow-Up Studies; Humans; Hyperemia; Osteitis Deformans; Plicamycin; Radionuclide Imaging; Regional Blood Flow; Technetium; Technetium Tc 99m Medronate

The results of skeletal scintigraphy with Tc-99m-medronate of five children, in whom bone or joint infection was suspected, are presented. They illustrate that the demonstration of areas of diminished radionuclide accumulation may be of considerable assistance in establishing a diagnosis.

Topics: Arthritis, Infectious; Bone and Bones; Child; Child, Preschool; Diphosphonates; Female; Hip Joint; Humans; Hyperemia; Infant; Infant, Newborn; Male; Osteomyelitis; Radionuclide Imaging; Staphylococcal Infections; Staphylococcus aureus; Technetium; Technetium Tc 99m Medronate